(197) PENILE FRACTURE MANAGEMENT AT TRAUMA CENTERS IN THE UNITED STATES

Abstract Introduction Current American Urological Association Urotrauma guidelines recommend prompt surgical intervention for patients presenting with acute penile fracture to minimize potential risks of erectile dysfunction and penile curvature. Given its relatively rare occurrence, there have been few large national studies evaluating real-world management of penile fracture. Objective To understand if there is variability in intervention for patients presenting with penile fracture associated with patients’ clinical and demographic characteristics and hospital characteristics. Methods The Trauma Quality Improvement Program (TQIP) database from 2007 to 2017 was analyzed and patients with diagnosis codes for penile fracture were identified. Patient demographic data and hospital characteristics were analyzed. Multivariable analysis was performed to identify patient and hospital characteristics associated with surgical intervention for penile fracture. Results We identified 940 patients presenting with penile fracture. The median age was 39 (quartiles: 31-47). Of the 940 patients, 658 (70%) of patients underwent surgery for penile fracture during index admission. On multivariable regression analysis, hospital teaching status, type of insurance, and concomitant urethral injury diagnosis were significantly associated with the likelihood of intervention. Conclusions In this large, retrospective study, most patients underwent guideline-based management. However, several patients did not have surgery at the time of their presentation, which was associated with presenting to a non-teaching hospital, using Medicaid or Medicare insurance, and the absence of urethral injury. TQIP is focused on trauma centers, thus this study may not reflect practice patterns across the United States. Further understanding of nonoperative management may improve adherence to guideline-based care. Disclosure No.