Malleable penile prosthesis is a cost-effective treatment for refractory ischemic priapism

Timothy J. Tausch, Lee C. Zhao, Allen F. Morey, Jordan A. Siegel, Michael J. Belsante, Casey Seideman, James R. Flemons

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Introduction: Refractory ischemic priapism (RIP) can be difficult to treat, consuming significant healthcare-related resources. Acute insertion of a malleable penile prosthesis (MPP) has been reported as an effective therapy that treats the priapism and restores sexual function. Aim: We report our 6-year, urban public hospital experience with acute insertion of MPP in patients with RIP. Methods: We retrospectively reviewed the records of patients receiving MPPs for RIP from 2007 to 2013. Data analyzed included duration of erection, number of emergency room (ER) visits, hospital admissions, days of hospitalization, and postoperative course. Costs were estimated using standard Medicare reimbursement rates. Main Outcome Measure: Healthcare-related costs of treatment of RIP episodes in men presenting to our institution. Results: During the study period, 14 men underwent MPP placement acutely for refractory priapism. Thirteen presented with RIP, and one had stuttering priapism over a 14-day hospitalization. Etiologies included sickle cell anemia (4/13, 29%), medication-induced (3/14, 21%), and idiopathic (7/14, 50%). Average preoperative duration of RIP was 82 hours with considerable consumption of health-care resources (average US $83,818 estimated cost, 4 ER visits [range 1-27], 2 hospital admissions [range 1-5], 1.5 shunt procedures [range 1-3], 5 irrigation and drainage procedures using phenylephrine injection [range 2-20], and 5 hospital admission days [range 2-14]). All patients were discharged within 24 hours of MPP surgery. Conclusions: The management of RIP is associated with multiple ER visits, prolonged hospital admissions, and significant resource utilization. MPP insertion is efficacious for the immediate resolution of refractory priapism, with potential cost and resource benefits.

Original languageEnglish (US)
Pages (from-to)824-826
Number of pages3
JournalJournal of Sexual Medicine
Volume12
Issue number3
DOIs
StatePublished - Mar 1 2015
Externally publishedYes

Fingerprint

Penile Prosthesis
Priapism
Health Care Costs
Hospital Emergency Service
Hospitalization
Delivery of Health Care
Costs and Cost Analysis
Stuttering
Health Resources
Public Hospitals
Urban Hospitals
Sickle Cell Anemia
Phenylephrine
Medicare
Cost-Benefit Analysis
Drainage

Keywords

  • Erectile dysfunction
  • Penile prosthesis
  • Priapism

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology
  • Urology

Cite this

Tausch, T. J., Zhao, L. C., Morey, A. F., Siegel, J. A., Belsante, M. J., Seideman, C., & Flemons, J. R. (2015). Malleable penile prosthesis is a cost-effective treatment for refractory ischemic priapism. Journal of Sexual Medicine, 12(3), 824-826. https://doi.org/10.1111/jsm.12803

Malleable penile prosthesis is a cost-effective treatment for refractory ischemic priapism. / Tausch, Timothy J.; Zhao, Lee C.; Morey, Allen F.; Siegel, Jordan A.; Belsante, Michael J.; Seideman, Casey; Flemons, James R.

In: Journal of Sexual Medicine, Vol. 12, No. 3, 01.03.2015, p. 824-826.

Research output: Contribution to journalArticle

Tausch, TJ, Zhao, LC, Morey, AF, Siegel, JA, Belsante, MJ, Seideman, C & Flemons, JR 2015, 'Malleable penile prosthesis is a cost-effective treatment for refractory ischemic priapism', Journal of Sexual Medicine, vol. 12, no. 3, pp. 824-826. https://doi.org/10.1111/jsm.12803
Tausch, Timothy J. ; Zhao, Lee C. ; Morey, Allen F. ; Siegel, Jordan A. ; Belsante, Michael J. ; Seideman, Casey ; Flemons, James R. / Malleable penile prosthesis is a cost-effective treatment for refractory ischemic priapism. In: Journal of Sexual Medicine. 2015 ; Vol. 12, No. 3. pp. 824-826.
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N2 - Introduction: Refractory ischemic priapism (RIP) can be difficult to treat, consuming significant healthcare-related resources. Acute insertion of a malleable penile prosthesis (MPP) has been reported as an effective therapy that treats the priapism and restores sexual function. Aim: We report our 6-year, urban public hospital experience with acute insertion of MPP in patients with RIP. Methods: We retrospectively reviewed the records of patients receiving MPPs for RIP from 2007 to 2013. Data analyzed included duration of erection, number of emergency room (ER) visits, hospital admissions, days of hospitalization, and postoperative course. Costs were estimated using standard Medicare reimbursement rates. Main Outcome Measure: Healthcare-related costs of treatment of RIP episodes in men presenting to our institution. Results: During the study period, 14 men underwent MPP placement acutely for refractory priapism. Thirteen presented with RIP, and one had stuttering priapism over a 14-day hospitalization. Etiologies included sickle cell anemia (4/13, 29%), medication-induced (3/14, 21%), and idiopathic (7/14, 50%). Average preoperative duration of RIP was 82 hours with considerable consumption of health-care resources (average US $83,818 estimated cost, 4 ER visits [range 1-27], 2 hospital admissions [range 1-5], 1.5 shunt procedures [range 1-3], 5 irrigation and drainage procedures using phenylephrine injection [range 2-20], and 5 hospital admission days [range 2-14]). All patients were discharged within 24 hours of MPP surgery. Conclusions: The management of RIP is associated with multiple ER visits, prolonged hospital admissions, and significant resource utilization. MPP insertion is efficacious for the immediate resolution of refractory priapism, with potential cost and resource benefits.

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