Predictors of intraoperative complications in men undergoing inflatable penile prosthesis placement - PubMed (original) (raw)

Multicenter Study

. 2025 Nov 2;22(11):2116-2122.

doi: 10.1093/jsxmed/qdaf136.

David W Barham 2, Martin S Gross 3, Chrystal Chang 4, Muhammed Hammad 5, Daniel Swerdloff 4, Jake Miller 5, Charles Loeb 5, Robert Andrianne 6, Arthur L Burnett 7, Kelli Gross 8, Georgios Hatzichristodoulou 9, James M Hotaling 7, Tung-Chin Hsieh 10, Lawrence C Jenkins 5, Adam Jones 11, Aaron C Lentz 12, Vaibhav Modgil 10, Daniar Osmonov 13, Sung H Park 14, Ian Pearce 10, Paul Perito 15, Hossein Sadeghi-Nejad 16, Maxime Sempels 5, Alfredo Suarez-Sarmiento Jr 14, Jay Simhan 4, Koenraad van Renterghem 17, Jonathan Nicholas Warner 18, Matthew Ziegelmann 17, Faysal A Yafi 5, On Behalf Of The Pump Prosthetic Urology Multi-Institutional Partnership Collaborators

Affiliations

Multicenter Study

Predictors of intraoperative complications in men undergoing inflatable penile prosthesis placement

James M Jones et al. J Sex Med. 2025.

Abstract

Background: Intracavernosal injection (ICI) therapy for erectile dysfunction (ED) and prostate cancer treatments all carry a risk of corporal fibrosis, potentially making placement of an inflatable penile prosthesis more difficult.

Aim: To evaluate the association between history of ICI, history of prostate cancer treatment (prostatectomy, radiation) and complications of inflatable penile prosthesis (IPP) placement.

Methods: A retrospective cohort study was performed of primary IPP cases from 2016 to 2021 across 16 institutions. Patients were stratified by development of intraoperative complications (crossover, corporal perforation, or urethral injury) and between-group differences in risk factors were assessed. Multivariable logistic regression was used to assess for predictors of intraoperative complications and postoperative infection.

Outcomes: The primary outcome was intraoperative complications, and secondary outcome was implant infection.

Results: A total of 2540 patients met inclusion criteria. Intraoperative complications occurred in 36 (1.4%) patients. On multivariable regression, a history of ICI, prostatectomy, and radiation were all significant predictors of intraoperative complications (OR 2.11, P = 0.03; OR 2.27, P = 0.03; OR 2.40, P = 0.04, respectively). Age, body mass index, diabetes, hypertension, vascular disease, smoking, and Peyronie's disease were not predictors of intraoperative complications. None of the variables were significant predictors of infection.

Clinical implications: Prosthetic urologists should counsel patients that a history of ICI or prostate cancer treatment with radical prostatectomy and/or radiation are associated with an increased risk of intraoperative complications.

Strengths and limitations: Strengths of this study include the utilization of a large, multicenter, international dataset. The study is limited by retrospective nature, a lack of granular data as to the type and duration of ICI therapy, and inherent selection bias in that all cases were performed by dedicated implant surgeons.

Conclusion: In men undergoing IPP placement, a history of ICI, a history of radical prostatectomy, and a history of radiation are all independently associated with increased risk of intraoperative complications.

Keywords: ICI; corporal fibrosis; erectile dysfunction; inflatable penile prosthesis; intracavernosal injection.

© The Author(s) 2025. Published by Oxford University Press on behalf of The International Society for Sexual Medicine. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.

PubMed Disclaimer

Publication types

MeSH terms

LinkOut - more resources