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New findings regarding the influence of assistants on surgical outcomes in penile prosthesis implantation

International Journal of Impotence Research volume 35, pages 736–740 (2023)Cite this article

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Abstract

Penile prosthesis implantation is the definitive treatment for refractory erectile dysfunction, yet exposure to this procedure during training of urology residents is often limited. To assess the effects of resident participation in penile prosthesis surgery, we compared surgical outcomes in a retrospective case series of 253 penile prosthesis surgeries by a single surgeon at the same institution between 2017 and 2020 with the assistance of either a registered nurse first assistant (RNFA) or a resident. Pertinent patient characteristics and surgical complications including device complications, surgical site infection, postoperative bleeding, iatrogenic injury, cardiovascular events, pulmonary events, and urinary retention were documented. Measured outcomes included operative time, Emergency Room (ER) visits, unplanned postoperative visits, pain medication refills, and surgical complications. Compared to RFNAs, resident-assisted penile prosthesis surgery was associated with significant increase in mean operative time (71.4 min vs. 87.9 min, p < 0.01) and postoperative ER visits (3.0% vs. 10.6%, p = 0.03) but not surgical complications (19.7% vs. 20.8%, OR 1.03, 95% CI [0.46 −2.30]) or other measured outcomes. Compared to a dedicated RFNA, Resident assistance increased operative time by approximately 17 min, but did not increase post-operative surgical complications, supporting the notion that resident assistance in these procedures may be appropriate as an integral part of training.

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Study data will be made available to interested parties upon direct request to the corresponding author.

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Authors and Affiliations

  1. Section of Urology, Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA

    Shuo-chieh Wu, Amanda R. Swanton & Martin S. Gross

  2. Geisel School of Medicine at Dartmouth, Hanover, NH, USA

    James M. Jones

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  1. Shuo-chieh Wu
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  2. Amanda R. Swanton
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  3. James M. Jones
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  4. Martin S. Gross
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Contributions

All authors have substantial contributions to this work. All authors were involved in the acquisition, analysis, and interpretation of data for the work, with final statistical analyses performed by SCW. SCW, ARS, JMJ, and MSG all contributed to drafting the paper and revised it critically for important intellectual content including final approval of the version to be published. All authors are in agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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Correspondence to Martin S. Gross.

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Wu, Sc., Swanton, A.R., Jones, J.M. et al. New findings regarding the influence of assistants on surgical outcomes in penile prosthesis implantation. Int J Impot Res 35, 736–740 (2023). https://doi.org/10.1038/s41443-022-00624-x

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