Current Findings Regarding Perioperative Complications in Benign Scrotal Surgery
Michael Rezaee, MD, MPH1, Amanda R. Swanton, MD, PhD2, Martin Gross, MD3.
1Brady Urological Institute, Johns Hopkins, Baltimore, MD, USA, 2Boston Medical Center, Boston, MA, USA, 3Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
BACKGROUND: Benign scrotal surgery is a core component of urology practice. Patients commonly pursue these procedures for pain control, increased comfort, and improved aesthetics. The potential risks of benign scrotal surgery have not been well described in the literature, particularly in the general adult population. We sought to characterize patients at the greatest risk of morbidity and mortality after benign scrotal surgery.
METHODS: A secondary data analysis was conducted of adults undergoing elective scrotal surgery for benign conditions using 2015-2020 American College of Surgeons National Surgical Quality Improvement data. Patients who experienced a postoperative complication, an unplanned procedure, or who died within 30-days of surgery were identified using the composite outcome “postoperative event”. Multiple logistic regression was used to examine the association between patient characteristics and the odds of experiencing a postoperative event.
RESULTS: The study consisted of 12,917 patients, of which 4.1% experienced a postoperative event. After adjustment, malnourishment (OR 4.1, 95% CI: 1.2 - 14.5) decreased functional status (OR 3.8, 95% CI: 2.0 - 7.1), bleeding disorders (OR 3.4, 95% CI: 2.2 - 5.4), age ≥ 40 years (OR 1.6, 95% CI: 1.2 - 2.0), chronic obstructive pulmonary disease, (COPD, OR 1.8, 95% CI: 1.2 - 2.6), smoking (OR 1.4, 95% CI: 1.2 - 1.8), diabetes (OR 1.3, 95% CI: 1.1 - 1.7) and increased body mass index (BMI, OR 1.1, 95% CI: 1.1-1.1) were identified as risk factors for a postoperative event. The risk of a postoperative event was 2.7%, 4.5%, and 11.2% for patients with none, 1 to 2, and > 2 risk factors, respectively.
CONCLUSIONS: Complications after benign scrotal surgery are not infrequent, but are also not as common as historically reported. Risk factors include malnourishment, decreased functional status, bleeding disorders, age, COPD, smoking, diabetes, and increased BMI. Our results can be used to counsel patients on their risk of negative outcomes following these procedures.
Back to 2022 Abstracts