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PD2-08 HIGH RISK OF PRIAPISM IN RECREATIONAL INTRACAVERNOSAL DRUG ABUSERS
THE JOURNAL OF UROLOGYâ
Vol. 193, No. 4S, Supplement, Friday, May 15, 2015
PD2-08 HIGH RISK OF PRIAPISM IN RECREATIONAL INTRACAVERNOSAL DRUG ABUSERS Gustavo Diaz*, Rafael Yanes, Akshay Bhandari, Alan Nieder, Miami Beach, FL INTRODUCTION AND OBJECTIVES: Priapism is a urological emergency that could be related to multiple etiologies. Recently, we have seen an increase in use of recreational intracavernosal drugs in our population presenting with priapism. We sought to ascertain the etiology of priapism at our center and characterize the use of illicit drugs. METHODS: After IRB approval, we performed a retrospective review of all charts for men presenting with priapism to the Emergency Room (ER) from July 2010 until June 2014. The information extracted included patient demographics, past medical history, history of substance abuse, etiology of priapism, delay in presentation to ER and treatment offered. RESULTS: We identified 57 patients with priapism. One patient with Sickle Cell Trait generated 19 visits and was excluded from the analysis. The remaining 56 patients generated a total of 64 visits. All cases were of low-flow priapism. The median patient age was 44 years. The median delay to presentation was 12 hours. The most common cause of priapism was recreational injections 56% (n¼36). It was found that 36% (n¼20) of all patients were HIVþ; of whom 95% (n¼19) presented due to recreational intracavernosal drug abuse. In this population, 21% (n¼12) of patients also used illicit drugs (i.e. marijuana, cocaine, methamphetamines and/or heroin). There was a statistically significant delay in presentation between recreational and non recreational intracavernosal users, median 18 and 7 hours, respectively (P <0.05) Non-surgical management was effective in 81% (n¼52) of cases. CONCLUSIONS: The use of recreational intracavernosal injections is a significant problem in our patient population. There was a statistically significant difference in the delay to presentation between recreational injections. Also, a high prevalence of HIVþ patients describes a unique population given our institution’s location. Despite delayed presentation, high non-operative resolution rate was achieved. Further studies are required to validate our findings at other cosmopolitan cities with high volume tourism. Also, increased educational resources and warning should be considered, especially for HIVþ men who utilize recreational intracavernosal drugs.
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satisfaction measured by the likelihood of choosing the surgery again, likelihood of recommending a TP to a friend, and overall rating of the TP was high. CONCLUSIONS: Firmness, inappropriate size and general discomfort were common complaints after TP placement. Despite this, most men gave a favorable overall rating for their prosthesis. This data can be helpful in counseling patients considering a TP.
Source of Funding: None
PD2-09 PATIENT SATISFACTION WITH TESTICULAR PROSTHESIS AFTER ORCHIECTOMY FOR TESTICULAR CANCER Brian Hu*, Hooman Djaladat, Sepehr Shojaei, Siamak Daneshmand, Los Angeles, CA INTRODUCTION AND OBJECTIVES: It can be difficult for the surgeon and patient to determine if implantation of a testicular prosthesis (TP) will result in a beneficial outcome. This, in part, is due to a paucity of data on long-term patient satisfaction. METHODS: Thirty-six patients who underwent orchiectomy and TP placement for testicular cancer participated in a survey that was blinded to the providers in an outpatient clinic (2012e2014). RESULTS: The age group between 25e34 years comprised the most common (44%) demographic. Most patients had the prosthesis in place for >1 year (78%). No patients reported complications from the TP and none required explant. The responses with respect to prosthesis characteristics (size, shape, weight, texture, and position) are shown in Figure 1. Firmness and an inappropriate size were the most common complaints. The overall satisfaction responses are shown in Figure 2. A high percentage (44%) of patients reported the TP to be uncomfortable or very uncomfortable. However, overall
Source of Funding: None
PD2-10 INFLATABLE PENILE PROSTHESIS FAILURE AND COMPLICATIONS: REVIEW OF A NATIONAL DATABASE Judith C. Hagedorn*, Nathan Osbun, Scott Lundy, Seattle, WA; Tanner Miest, Rochester, MN; Bryan B. Voelzke, Seattle, WA INTRODUCTION AND OBJECTIVES: No study to date has assessed the reported failure/complications of inflatable penile prostheses (IPP) from a national database. The aim of the study is to describe the failure and complication rate as reported by the Food and Drug Administration.
Vol. 193, No. 4S, Supplement, Friday, May 15, 2015
PD2-08 HIGH RISK OF PRIAPISM IN RECREATIONAL INTRACAVERNOSAL DRUG ABUSERS Gustavo Diaz*, Rafael Yanes, Akshay Bhandari, Alan Nieder, Miami Beach, FL INTRODUCTION AND OBJECTIVES: Priapism is a urological emergency that could be related to multiple etiologies. Recently, we have seen an increase in use of recreational intracavernosal drugs in our population presenting with priapism. We sought to ascertain the etiology of priapism at our center and characterize the use of illicit drugs. METHODS: After IRB approval, we performed a retrospective review of all charts for men presenting with priapism to the Emergency Room (ER) from July 2010 until June 2014. The information extracted included patient demographics, past medical history, history of substance abuse, etiology of priapism, delay in presentation to ER and treatment offered. RESULTS: We identified 57 patients with priapism. One patient with Sickle Cell Trait generated 19 visits and was excluded from the analysis. The remaining 56 patients generated a total of 64 visits. All cases were of low-flow priapism. The median patient age was 44 years. The median delay to presentation was 12 hours. The most common cause of priapism was recreational injections 56% (n¼36). It was found that 36% (n¼20) of all patients were HIVþ; of whom 95% (n¼19) presented due to recreational intracavernosal drug abuse. In this population, 21% (n¼12) of patients also used illicit drugs (i.e. marijuana, cocaine, methamphetamines and/or heroin). There was a statistically significant delay in presentation between recreational and non recreational intracavernosal users, median 18 and 7 hours, respectively (P <0.05) Non-surgical management was effective in 81% (n¼52) of cases. CONCLUSIONS: The use of recreational intracavernosal injections is a significant problem in our patient population. There was a statistically significant difference in the delay to presentation between recreational injections. Also, a high prevalence of HIVþ patients describes a unique population given our institution’s location. Despite delayed presentation, high non-operative resolution rate was achieved. Further studies are required to validate our findings at other cosmopolitan cities with high volume tourism. Also, increased educational resources and warning should be considered, especially for HIVþ men who utilize recreational intracavernosal drugs.
e43
satisfaction measured by the likelihood of choosing the surgery again, likelihood of recommending a TP to a friend, and overall rating of the TP was high. CONCLUSIONS: Firmness, inappropriate size and general discomfort were common complaints after TP placement. Despite this, most men gave a favorable overall rating for their prosthesis. This data can be helpful in counseling patients considering a TP.
Source of Funding: None
PD2-09 PATIENT SATISFACTION WITH TESTICULAR PROSTHESIS AFTER ORCHIECTOMY FOR TESTICULAR CANCER Brian Hu*, Hooman Djaladat, Sepehr Shojaei, Siamak Daneshmand, Los Angeles, CA INTRODUCTION AND OBJECTIVES: It can be difficult for the surgeon and patient to determine if implantation of a testicular prosthesis (TP) will result in a beneficial outcome. This, in part, is due to a paucity of data on long-term patient satisfaction. METHODS: Thirty-six patients who underwent orchiectomy and TP placement for testicular cancer participated in a survey that was blinded to the providers in an outpatient clinic (2012e2014). RESULTS: The age group between 25e34 years comprised the most common (44%) demographic. Most patients had the prosthesis in place for >1 year (78%). No patients reported complications from the TP and none required explant. The responses with respect to prosthesis characteristics (size, shape, weight, texture, and position) are shown in Figure 1. Firmness and an inappropriate size were the most common complaints. The overall satisfaction responses are shown in Figure 2. A high percentage (44%) of patients reported the TP to be uncomfortable or very uncomfortable. However, overall
Source of Funding: None
PD2-10 INFLATABLE PENILE PROSTHESIS FAILURE AND COMPLICATIONS: REVIEW OF A NATIONAL DATABASE Judith C. Hagedorn*, Nathan Osbun, Scott Lundy, Seattle, WA; Tanner Miest, Rochester, MN; Bryan B. Voelzke, Seattle, WA INTRODUCTION AND OBJECTIVES: No study to date has assessed the reported failure/complications of inflatable penile prostheses (IPP) from a national database. The aim of the study is to describe the failure and complication rate as reported by the Food and Drug Administration.