Partner Involvement Reduces Postoperative Care Burden Following Penile Prosthesis Placement
Amanda R. Swanton, MD/PhD1, Ricardo M. Munarriz, MD2, Martin S. Gross, MD1.
1Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA, 2Boston University School of Medicine, Boston, MA, USA.
BACKGROUND: The spouses and partners of patients undergoing implantation of an inflatable penile prosthesis (IPP) are often active participants in the perioperative process. Many urologists encourage partner involvement for penile implant patients, but there is little information on the role partners play perioperatively. We analyzed the effect of perioperative partner involvement on planned postoperative care.
METHODS: This is a retrospective study conducted using data obtained from primary IPPs performed by a single surgeon between October 2016 and January 2021. A standardized postoperative course was used, including planned follow-up visits at 2 weeks (for wound check and device deflation) and 6 weeks (for device teaching). Patient characteristics, including demographics, partner involvement, and the number of follow-up visits were obtained from the medical record. Logistic regression modeling was performed to determine the influence of partner involvement on planned postoperative scheduled visits.
RESULTS: During the study period, n = 170 primary IPP patients were identified and 147 (67%) of these patients had partners. Partners were involved in all perioperative visits for 92 patients (54%). Unplanned follow up visits were seen for 58 patients (34%) between 0-6 weeks and for 28 patients (17%) after 6 weeks postoperatively.
Partner involvement was associated with a reduced odds of additional follow up visits, both at 0-6 weeks (unadj: OR 0.43, 95% CI 0.23-0.83; adj: OR 0.40, 95% CI 0.20-0.79) and after 6 weeks (unadj: OR 0.32, 95% CI 0.13-0.76; adj: OR 0.33, 95% CI 0.13-0.81), both in unadjusted analysis and when adjusted for obesity and presence of complications.
Clavien-Dindo complications were identified in 29 patients (17%) intraoperatively or postoperatively. Mean surgical time was 69 minutes (SD = 19). Mean patient age was 62 years (SD = 9). Comorbidities included obesity (52%), diabetes (37%), hyperlipidemia (72%), and hypertension (84%).
CONCLUSIONS: Partner involvement equated to a 2.5 fold decrease in the odds of unplanned postoperative visits among primary IPP patients. Though the mechanism of this reduction is unclear, having partners attend perioperative visits is easily implemented, low cost, and minimal risk. We would recommend that urologists routinely encourage patients considering insertion of a penile prosthesis involve their partners in perioperative visits.
Back to 2021 Abstracts