Recommended Citation
Majdalany SE, Yaguchi G, Bazzi M, Jamil ML, Dabaja AA, and Rambhatla A. Peri-operative considerations for inflatable penile prosthesis: A same-day discharge pathway. Urol Video J 2023; 20.
Document Type
Article
Publication Date
10-1-2023
Publication Title
Urology Video J
Abstract
Introduction & objectives: Inflatable penile prosthesis (IPP) procedures can be complicated by peri‑operative care, hospital stays, and post-operative narcotics. A same-day discharge pathway with thorough care can help reduce complications and narcotics.
Materials & methods: We present three patients who underwent IPP procedures following our same-day discharge pathway. Once sterilized, patients receive bilateral pudendal nerve blocks (0.5 % Marcaine (5 mL), followed by a dorsal penile nerve block and ring blocks from 9 o'clock to 12 o'clock and 12 o'clock to 3 o'clock position. All our IPP procedures begin with a 3 cm transverse incision into the penoscrotal junction, dissecting down the dartos layer to identify the urethra and corpora on either side completing the procedure in a standard fashion. At the end of the procedure, scrotum is then closed with 4–0 Monocryl sutures in a running horizontal mattress fashion. The device was once again tested, and the cylinders appeared to inflate without any buckling or lateral bulging. Surgical adhesive glue was applied to the skin and a compressive scrotal and penile wrap dressing was placed.
Results: Upon discharge patients are prescribed: Tylenol, Motrin, Robaxin, Gabapentin, and Bactrim for 7 days. Post-operative care instructions include: (1) POD 1 remove Foley catheter (2) Drinking fluids and returning to normal diet as tolerated, (3) Raise legs while seated, (4) POD 2, home-removal of compression dressing, (5) Maintain scrotal support until 2 week visit, (6) Maintain penis position with head up on abdomen, (7) Decrease swelling by placing an ice pack on scrotal support for 2–3 days, and 8) Return at 4–6 weeks for teaching and proper use of IPP.
Conclusions: We present our technique of same-day discharge for patients undergoing an inflatable penile prosthesis, outlining peri‑operative considerations. To date we have performed 42 cases using this same-day discharge pathway. One case was aborted due to bladder injury and a malleable was placed instead, so this pathway was not used. Since implanting our standard discharge protocol, we have not prescribed any narcotics and have not received any patient inquiries for them.
PubMed ID
Not assigned.
Volume
20
