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Title: | Prior radiation therapy is associated with increased risk of intra-operative complications in patients undergoing primary inflatable penile prosthesis placement: Results from a large multi-institutional collaborative | Authors: | Dalimov, Z. Diao, L. Chang, C. Barham, D. W. Sadeghi-Nejad, H. Hamma, M. A. M. Andrianne, R. Sempels, M. Hsieh, T. Hatzichristodoulou, G. Osmonov, D. Lentz, A. Perito, P. Hotaling, J. VAN RENTERGHEM, Koenraad Park, S. H. Ziegelmann, M. Pearce, I Yafi, F. A. Simhan, J. |
Issue Date: | 2024 | Publisher: | OXFORD UNIV PRESS | Source: | Journal of Sexual Medicine, 21 (S1) (Art N° 181) | Abstract: | Introduction: Radiation therapy (RT) can predispose the onset of corporal fibrosis and microvasculopathy. The impact of RT on intra-operative complications is not well described in the literature. Objective: In this study, we assess intra-operative and post-operative outcomes among patients with or without prior history of RT following primary Inflatable Penile Prosthesis (IPP) implantation. Methods: We performed a multicenter, retrospective analysis of men undergoing primary IPP placement between January 2015 and December 2022. A total of 3530 patients were identified, of which 3319 had no prior history of RT and 211 patients had history of RT. After 1:1 propensity score matching for all confounding variables, 211 patients with a history of RT were compared to 211 nonradiated patients for intra-operative and post-operative outcomes. Chi-square and Mann-Whitney tests were used for statistical analysis for categorial and continuous variables respectively. For multivariable analysis, we used a forward stepwise model and included significant variables found on pre-operative characteristics of patients. Kaplan-Meier time to event analysis were compared with Mantel-Cox log-rank test. Results: Patients with history of RT encountered more intra-operative complications (4.3% vs 0.9%, p=0.032); specifically , these men experienced more distal crossover events (1.9% vs 0, p=0.044). On multivariable analysis, history of prior RT (OR 5.29, 95% CI 1.07-26.3, p=0.041) and diabetes mellitus (OR 10.5, 95% CI 2.58-43.5, p=0.01) were associated with increased risk of intra-operative complications. History of obesity (OR 0.11, 95% CI 0.01-0.91, p=0.040) reduced risk of intra-operative complications. There was no significant difference in early or late post-operative non-infectious complications between both groups and there was also no significant difference in risk of post-operative complications within 24 months on Kaplan Meier analysis (log rank p=0.9). Conclusions: In this large multi-institutional cohort, history of RT is an independent predictor of intra-operative complications but not post-operative complications during primary IPP placement. These findings may help inform patient-specific counseling while guiding surgical planning to prevent untoward morbidity following surgery. Disclosure: No. | Document URI: | http://hdl.handle.net/1942/42706 | ISSN: | 1743-6095 | e-ISSN: | 1743-6109 | DOI: | 10.1093/jsxmed/qdae001.171 | ISI #: | 001158229800252 | Category: | M | Type: | Journal Contribution |
Appears in Collections: | Research publications |
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