Abstracts from the Abstracts from the Mid-Atlantic Section of the AUA 2021

MA-AUA 2021 Abstracts Display Posters Single Institution Review of Prevena Epidermal Wound VacuumUsage in Patients Undergoing Inguinal Lymph Node Dissection for Penile Cancer J. Farhi, S. Culp University of Virginia, Charlottesville, VA, USA Introduction and Objective: Inguinal lymphadenectomy (ILND) can be fraught with wound complications. These include flap necrosis, lymphocele, lymphedema, wound infection and dehiscence. Our institution began using the Prevena epidermal vacuum (VAC) for ILND in 2019. Theoritically epidermal vacuum (VAC) device may lead to sealing of lymphatic vessels through sub-atmospheric pressure thereby reducing wound complication rate. Our objective was to review our initial experience. Methods: Patients were identified who underwent ILND for high risk penile cancer by a single surgeon (SHC) at the University of Virginia. All superficial and deep ILND were performed using the standard template. VACs were placed over each closed incision with the equipment representative present. Incisions were closed with deep dermal interrupted Vicryl suture and running Monocryl subcuticular suture. Jackson Pratt drains were placed in the dissection beds. The VAC was removed at home on post-operative day 7. Drains were removed after output was < 50 cc over 24 hours. Results: We identified 7 patients undergoing ILND with VAC placement between August 2019 and January 2021. Average age was 66 years old [95% CI 59, 73] and average body mass index was 28.5 kg/m 2 [95% CI 24.4, 32.6]. Although no patients had diabetes, 4 patients were current every-day smokers. Average number of lymph nodes per side in ILND removed was 11.3 (SD 2.9). All patients were discharged home on post-operative day 1. One patient required readmission for lymphedema. Complications and tumor stages are listed in Table 1. Conclusions: This case series suggests acceptable wound outcomes in patients undergoing ILNDwith VAC. Our results support potential initiation of a randomized prospective trial with VAC in order to provide level 1 evidence for its routine usage. DP-05 Perioperative Cost ComparisonBetween PercutaneousMicrowaveAblation vs. Partial Nephrectomy for Small Renal Masses C. Yeaman, J. Lobo, A. DeNovio, L. O’Connor, R. Marchant, C. Ballantyne, N. Schenkman University of Virginia, Charlottesville, VA, USA Introduction and Objective: To determine and compare the perioperative cost associated with percutaneous microwave ablation (MWA) and partial nephrectomy for treatment of small renal masses. Methods: We conducted a retrospective cohort analysis of a prospectively maintained IRB approved small renal mass database. The database was queried for patients treated with either microwave ablation or partial nephrectomy from 2015-2020. Financial costs related to the procedural encounter and costs related to complications were collected. Total cost is represented by the sum of medical center cost and physician related cost. Statistical analysis was performed in SAS using Student’s T-Test andWilcoxon Rank-Sum Test. Results: Atotal of 279 patients were identified, 165 patients underwent MWA and 114 underwent partial nephrectomy. All partial nephrectomies were robotic-assisted. The mean total cost was $20,536 for partial nephrectomy and $6,470 for MWA (p<0.0001). Five patients (3%) who underwent MWA experienced major complications (Clavien-Dindo 3 or greater), and eight patients (7%) who underwent partial nephrectomy experienced complications. For those patients who underwent MWA and did not have a major complication had an average medical center cost of $5,174 compared to $8,990 for those with a complication (p=0.36). For those patients who underwent partial nephrectomy, those who had a major complication had an average medical center cost of $15,138 compared to $28,940 for those who did have a complication (p=0.008). Conclusions: MWA demonstrates lower perioperative cost than partial nephrectomy for treatment of small renal masses. Further, complications that occurred related to MWA were less costly than those incurred from partial nephrectomy, however our study did not evaluate long term cost attributable to local recurrence. Updated cost-effectiveness studies for small renal mass treatment should be performed with this updated cost information. DP-04 47