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Vol. 44. Issue 5.
Pages 262-267 (June 2020)
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Vol. 44. Issue 5.
Pages 262-267 (June 2020)
REVIEW ARTICLE
DOI: 10.1016/j.acuroe.2020.05.002
Analysis of satisfaction and surgical outcomes of a major ambulatory surgery program for penile implant
Análisis de satisfacción y resultados quirúrgicos de un programa de cirugía mayor ambulatoria para el implante de prótesis de pene
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N. Picola, J. Torremade
Corresponding author
, M. Fiol, J.J. Fernández-Concha, S. Beato, F. Vigués
Departamento de Urología, Hospital Universitario de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
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Tables (4)
Table 1. Demographic data and clinical characteristics of the patients operated on in a MAS regimen.
Table 2. Characteristics of the PP implanted on MAS.
Table 3. Postoperative complications of PP: outpatient vs. inpatient basis.
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Abstract
Introduction and objective

Penile prosthesis (PP) surgery is performed in many institutions as an inpatient procedure. We have recently initiated a major ambulatory surgery (MAS) program, thus reducing the hospital stay.

The objective of this study was to assess the feasibility, complications and satisfaction of the implantation of outpatient surgery PP program in our hospital.

Material and methods

Retrospective observational study evaluating the results and satisfaction of PP implanted as an outpatient procedure in Bellvitge University Hospital during 2018.

Results

During 2018 we implanted 49 PP: 27 (55%) inpatient surgeries vs. 22 (45%) outpatient surgeries. Of these 22, 2 (9%) were second implants. All patients underwent both general anesthesia and crural, proximal dorsal nerve and transversus abdominis plane block (TAP). Complication rates between inpatient and outpatient procedures were similar, 2 (7%) and 1 (5%), respectively, without reporting infections or requiring PP removal.

Postoperatively, a satisfaction telephone survey was conducted in 19 (86%) patients: 16 (84%) considered the time of hospital stay as appropriate, 15 (79%) would have preferred to be operated again in an outpatient care setting and 15 (79%) would recommend it. The patients’ main concerns were related to being at home with no medical assistance at home and about coming back the next day for drainage removal. All patients reported well-controlled pain without requiring opioid intake in any case.

Conclusions

In our series, PP implantation in an ambulatory care setting is feasible and safe. Although there are some aspects that should be improved, the program showed acceptable satisfaction rates and an adequate postoperative pain control, neither raising the administration of opioids, nor increasing complications and re-admission rates.

Keywords:
Penile prosthesis
Outpatient surgery
Analgesia
Resumen
Introducción y objetivo

El implante de prótesis de pene (PP) es llevado a cabo en muchos centros como régimen de hospitalización. Recientemente en nuestro centro hemos iniciado su realización como cirugía mayor ambulatoria (CMA), reduciendo la estancia hospitalaria.

El objetivo de este estudio ha sido evaluar la viabilidad, complicaciones y satisfacción de las PP implantadas en CMA en nuestro centro.

Material y métodos

Estudio observacional retrospectivo de los resultados y satisfacción de las PP realizadas en CMA en el Hospital Universitario de Bellvitge durante 2018.

Resultados

En 2018 se realizaron 49 PP: 27 (55,1%) hospitalizadas y 22 (44,9%) ambulatorias. De estas 22, 2 (9,1%) fueron segundos implantes. Los pacientes recibieron anestesia general y bloqueo locorregional crural, dorsal del pene y del plano transverso del abdomen (TAP). Las tasas de complicaciones entre hospitalizados y CMA fueron similares, 2 (7%) y 1 (5%) respectivamente, sin reportar ningún caso de infección ni requerir la retirada del implante.

Postoperatoriamente se realizó una encuesta telefónica contactando a 19 (86%) pacientes: 16 (84%) consideraron adecuado el tiempo de estancia, 15 (79%) volverían a intervenirse en CMA y 15 (79%) lo recomendarían, siendo el motivo de reticencia la preocupación por la falta de asistencia médica en el domicilio y evitar volver a las 24h para retirar el drenaje. Todos tuvieron buen control del dolor sin requerir mórficos en el postoperatorio.

Conclusiones

En nuestra serie, el implante de PP en CMA ha resultado ser viable y seguro. A pesar de que existen puntos de mejoría, se mantiene una correcta satisfacción del paciente y buen control del dolor, sin implicar un aumento de las complicaciones ni readmisiones.

Palabras clave:
Prótesis de pene
Cirugía mayor ambulatoria
Analgesia

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