TY - JOUR
T1 - Malleable penile prosthesis is a cost-effective treatment for refractory ischemic priapism
AU - Tausch, Timothy J.
AU - Zhao, Lee C.
AU - Morey, Allen F.
AU - Siegel, Jordan A.
AU - Belsante, Michael J.
AU - Seideman, Casey A.
AU - Flemons, James R.
N1 - Publisher Copyright:
© 2014 International Society for Sexual Medicine.
PY - 2015/3/1
Y1 - 2015/3/1
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.
AB - 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.
KW - Erectile dysfunction
KW - Penile prosthesis
KW - Priapism
UR - http://www.scopus.com/inward/record.url?scp=84923913906&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84923913906&partnerID=8YFLogxK
U2 - 10.1111/jsm.12803
DO - 10.1111/jsm.12803
M3 - Article
C2 - 25536880
AN - SCOPUS:84923913906
SN - 1743-6095
VL - 12
SP - 824
EP - 826
JO - Journal of Sexual Medicine
JF - Journal of Sexual Medicine
IS - 3
ER -