关于阴茎植入物受者身体完整性不良预测因素的新发现：一项多中心国际调查

IF 3.7 2区医学 Q1 UROLOGY & NEPHROLOGY

BJU International Pub Date : 2024-12-11 DOI:10.1111/bju.16607

Chrystal Chang, David W. Barham, Zafardjan Dalimov, Daniel Swerdloff, Hossein Sadeghi‐Nejad, Robert Andrianne, Maxime Sempels, Tung‐Chin Hsieh, Georgios Hatzichristodoulou, Muhammed Hammad, Jake Miller, Daniar Osmonov, Aaron Lentz, Paul Perito, Alfredo Suarez‐Sarmiento, James Hotaling, Kelli Gross, James M Jones, Koenraad van Renterghem, Sung Hun Park, Jonathan N. Warner, Matthew Ziegelmann, Vaibhav Modgil, Adam Jones, Ian Pearce, Arthur L. Burnett, Martin S. Gross, Faysal A. Yafi, Jay Simhan

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On multivariable analysis, predictors of PCI included revision IPP surgery (odds ratio [OR] 8.16, 95% confidence interval [CI] 5.15–12.92; P < 0.001), sequential dilatation (OR 2.12, 95% CI 1.32–3.39; P = 0.002), coronary artery disease (CAD)/peripheral vascular disease (PVD) (OR 1.81, 95% CI 1.18–2.77; P = 0.006), older age (OR 1.02, 95% CI 1.01–1.04; P = 0.013), and corporal scarring (OR 1.58, 95% CI 1.0–2.5; P = 0.049). Predictors of iPCI included revision IPP surgery (OR 7.34, 95% CI 4.18–12.88; P < 0.001), corporal scarring (OR 2.77, 95% CI 1.64–4.69; P < 0.001), radiation therapy (OR 2.25, 95% CI 1.0–5.04; P = 0.049), and older age (OR 1.03, 95% CI 1.0–1.05; P = 0.025). 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引用次数: 0

摘要

目的评估充气阴茎假体（IPP）置入后影响体体完整性的术前和术中变量，因为术中体体穿孔和延迟性假体并发症的预测因素尚未得到很好的表征。患者和方法我们回顾性地回顾了2016年至2021年由经验丰富的种植者进行的IPP手术的16个中心多机构数据库。下体完整性差（PCI）定义为术中（iPCI）下体并发症或术后（pPCI）下体并发症。进行多变量分析以确定PCI、iPCI和pPCI的独立预测因子。主要结局包括体内和术后的身体并发症。结果从5406例IPP患者中筛选出5153例进行分析，其中152例（2.95%）行PCI。在多变量分析中，PCI的预测因素包括改良IPP手术(优势比[OR] 8.16, 95%可信区间[CI] 5.15-12.92；P & lt;0.001)，序贯扩张(OR 2.12, 95% CI 1.32-3.39；P = 0.002)，冠状动脉疾病(CAD)/外周血管疾病（PVD） (OR 1.81, 95% CI 1.18-2.77；P = 0.006)，年龄较大(OR 1.02, 95% CI 1.01-1.04；P = 0.013)和体表疤痕(OR 1.58, 95% CI 1.0-2.5；P = 0.049)。iPCI的预测因素包括改良IPP手术(OR 7.34, 95% CI 4.18-12.88；P & lt;0.001)，体表疤痕(OR 2.77, 95% CI 1.64-4.69；P & lt;0.001)，放射治疗(OR 2.25, 95% CI 1.0-5.04；P = 0.049)，年龄越大(OR 1.03, 95% CI 1.0-1.05；P = 0.025)。改良IPP手术(OR 7.92, 95% CI 3.69-17.01；P & lt;0.001)，序贯扩张(OR 3.4, 95% CI 1.61-7.19；P = 0.001), cad / pvd (or 2.98, 95% ci 1.56-5.72；P = 0.001)，以及阴茎勃起史(OR 3.59, 95% CI 1.08-11.99；P = 0.038)预测pPCI。结论冠状动脉疾病/PVD、年龄较大、有体瘢痕、接受IPP翻修手术和序贯扩张是PCI相关并发症的预测危险因素。识别有PCI风险的患者可以改善患者特异性咨询，考虑转诊给更有经验的植入者，并制定手术计划，以潜在地提高设备的长期生存能力。

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New findings regarding predictors of Poor Corporal Integrity in Penile Implant Recipients: A Multicenter International Invesigation

ObjectivesTo evaluate the pre‐ and intraoperative variables that impact the integrity of the corporal bodies over time after inflatable penile prosthesis (IPP) placement, as predictors of intraoperative corporal perforation and delayed cylinder complications have not been well characterized.Patients and MethodsWe retrospectively reviewed a 16‐centre multi‐institutional database of IPP surgeries performed by experienced implanters from 2016 to 2021. Poor corporal integrity (PCI) was defined as intraoperative (iPCI) corporal complications or postoperative (pPCI) corporal complications. Multivariable analysis was performed to identify independent predictors of PCI, iPCI, and pPCI. Primary outcomes included intra‐ and postoperative corporal complications.ResultsWe identified 5153 patients for analysis from 5406 IPP cases, finding 152 (2.95%) cases of PCI. On multivariable analysis, predictors of PCI included revision IPP surgery (odds ratio [OR] 8.16, 95% confidence interval [CI] 5.15–12.92; P < 0.001), sequential dilatation (OR 2.12, 95% CI 1.32–3.39; P = 0.002), coronary artery disease (CAD)/peripheral vascular disease (PVD) (OR 1.81, 95% CI 1.18–2.77; P = 0.006), older age (OR 1.02, 95% CI 1.01–1.04; P = 0.013), and corporal scarring (OR 1.58, 95% CI 1.0–2.5; P = 0.049). Predictors of iPCI included revision IPP surgery (OR 7.34, 95% CI 4.18–12.88; P < 0.001), corporal scarring (OR 2.77, 95% CI 1.64–4.69; P < 0.001), radiation therapy (OR 2.25, 95% CI 1.0–5.04; P = 0.049), and older age (OR 1.03, 95% CI 1.0–1.05; P = 0.025). Revision IPP surgery (OR 7.92, 95% CI 3.69–17.01; P < 0.001), sequential dilatation (OR 3.4, 95% CI 1.61–7.19; P = 0.001), CAD/PVD (OR 2.98, 95% CI 1.56–5.72; P = 0.001), and history of priapism (OR 3.59, 95% CI 1.08–11.99; P = 0.038) were predictive of pPCI.ConclusionCoronary artery disease/PVD, being of older age, having corporal scarring, undergoing IPP revision surgery and sequential dilatation were predictive risk factors for complications associated with PCI. Identifying patients who are at risk of having PCI may improve patient‐specific counselling, consideration of referral to more experienced implanters, and surgical planning to potentially promote longer‐term device viability.

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来源期刊

BJU International 医学-泌尿学与肾脏学

CiteScore

9.10

自引率

4.40%

发文量

262

审稿时长

1 months

期刊介绍： BJUI is one of the most highly respected medical journals in the world, with a truly international range of published papers and appeal. Every issue gives invaluable practical information in the form of original articles, reviews, comments, surgical education articles, and translational science articles in the field of urology. BJUI employs topical sections, and is in full colour, making it easier to browse or search for something specific.