Abstracts from the New England Section of the AUA 2021

© The Canadian Journal of Urology TM : International Supplement, October 2021 Scientific Session V: ED/Infertility 50 Satisfaction Rates of Inflatable Penile Prosthesis in Men Who Have Sex with Men Justin La, MD 1 , Eric Chung, MD 2 , Rutul D. Patel, MBS 3 , Martin S. Gross, MD 4 , Georgios Hatzichristodoulou, MD 5 , Sean H. Park, MD 6 , Paul E. Perito, MD 7 , Alfredo S. Sarmiento, MD 7 , Koenraad Van Renterghem, MD 8 1 University of California, Irvine, Orange, CA, USA; 2 Androurology Centre, Brisbane, Australia; 3 New York Institute of Technology of Osteopathic Medicine, Old Westbury, NY, USA; 4 Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA; 5 Julius-Maximilians-University of Wurzburg, Wurzburg, Germany; 6 Sewum Prosthetic Urology Center of Excellence, Seoul, Korea, Republic of; 7 Perito Urology, Coral Gables, FL, USA; 8 Jessa Hospital Hasselt, Hasselt, Belgium Introduction: Men with erectile dysfunction have high patient satisfaction after placement of inflatable penile prostheses (IPP), but the impact on satisfaction and quality of life has never been studied in men who have sex with men (MSM) with erectile dysfunction. This study aims to assess the satisfaction rates and quality of life of MSM after placement of IPP for erectile dysfunction. Materials & Methods: A multi-institutional, retrospective study enrolled adult men who self-identified as MSM and underwent inflatable penile prosthesis placement with eitherAMS 700 TM LGX,AMS 700 TM CX or Coloplast Titan TM models. Two questionnaires were administered at one timepoint post-operatively. The Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) is a 11-item validated questionnaire measured on a 0-100 scale. The Quality of Life and Sexuality with Penile Prosthesis (QoLSPP) is a 16-item questionnaire subcategorized into 4 domains: functional, relational, social, and personal. Fisher’s exact test and paired t-test were used to calculate significance with p-values <0.05 considered significant. Results: Forty-nine MSM were assessed with a median age of 62 years (interquartile range [IQR], 53-69) withmedian follow-up of 14.2 months (IQR, 8.1-21.9). AMS 700 TM LGX, AMS 700 TM CX or Coloplast Titan TM IPPs were placed 2, 2 and 45 men, respectively. For the entire cohort, the median EDITS score was 93 (IQR, 91-95) and the median QoLSPP scores each domain were functional 23/25 (IQR, 22-24), relational 17/20 (IQR, 15-18), social 15/15 (12- 15), personal 18/20 (IQR, 17-19) with a total of 72/80 (IQR, 68-76). Conclusions: MSM report high satisfaction rates and quality of life after IPP placement for ED. Table 1. Patient baseline characteristics QR = interquartile range; SHIM = Sexual Health Inventory for Men A Multicenter Investigation Examining Timing of Penile Prosthesis Infections and Responsible Organisms Michael E. Rezaee, MD, MPH 1 , Amanda R. Swanton, MD, PhD 1 , Martin S. Gross, MD 1 , Ricardo M. Munarriz, MD 2 1 Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA; 2 Boston Medical Center, Boston, MA, USA Introduction: Penile prosthesis infections are thought to occur either shortly after surgery or in a delayed fashion. Differences in responsible organism pathogenicity is believed to explainwhy some patients present with infections later compared to others (i.e. acute vs. indolent infections). However, in the era of antibiotic-coated devices and increasing antibiotic resistance, little is known about current patterns in timing of device infections. Therefore, we sought to examine the timing of penile prosthesis infections by different responsible organisms. Materials &Methods: We performed a retrospective cohort study of patients who underwent penile prosthesis salvage or explant procedures due to infection between 2001 and 2018. Patients were followed for three years. The primary outcome of interest was time to penile prosthesis infection, which was defined as the number of months from initial implant to a salvage or explant procedure. Intraoperative culture datawas reviewed for each infection and grouped by responsible organism, including no growth cultures, gram positives (GPs), gramnegatives (GNs), yeast and anaerobes. Cox proportional hazardmodels were used to compare median time to infection by responsible organism and pre-operative antibiotic regimen. Chi-square analysis was used to examine the type of salvage procedure used for early (< 3 months) and delayed infections (> 3 months). Results: The study sample consisted of 225 patients from 33 implanters across 6 different countries. Intraoperative culture data showed no growth in 30.2% of cases. The most common organisms responsible for infections included GPs (31.6%), GNs (22.2%), Yeast (12.0%), and Anaerobes (4.0%). Median time to infection was 2 months and did not significantly differ by responsible organism (p=0.52): yeast (3 months), GPs (2 months), no growth cultures (2 months), anaerobes (2 months), and GNs (1.3 months, Figure 1). Infections were polymicrobial in 23.6% of cases. Median time to infection did not differ significantly between single organism (2months) and polymicrobial infections (1 month, p=0.92). Similarly, median time to infection did not significantly differ by type of pre-operative antibiotic regimen (p=0.22). A higher proportion of patients with delayed infections underwent device explant (37.4% vs. 50.0%) and three piece salvage (25.2% vs. 28.4%) compared to those with early infections, while those with delayed infections underwent fewer malleable salvage procedures (37.4% vs. 21.6%, p=0.02). Conclusions: Two-thirds of penile prosthesis infections occur within 3months of surgery. Median time to device infection is similar amongst responsible organisms as well as pre-operative antibiotic regimens. These findings may suggest that more indolent infections are less common in the age of antibiotic- coated devices and increasing antibiotic resistance. 49 26