(019) CONTEMPORARY FINDINGS REGARDING THE EFFICACY AND SAFETY OF THE “DRAIN AND RETAIN” MANEUVER FOR UROLOGIC PROSTHETIC RESERVOIRS DURING INFLATABLE PENILE PROSTHESIS REVISION SURGERY

Abstract Introduction Urologic prosthetic reservoirs (UPR) can become firmly adherent to surrounding structures, and their removal during revision surgeries carries significant risks. Over the last decade, the “drain and retain” maneuver has been increasingly implemented to safely leave decommissioned UPRs in place. The utility and safety of this technique have not been further explored in the literature following the original descriptive publications. Objective We sought to update the efficacy and safety of the “drain and retain” maneuver by analyzing a contemporary multi-institutional cohort. Methods Patients who underwent inflatable penile prosthesis (IPP) surgery at seven busy penile implant centers in the United States between July 2016 and June 2024 were reviewed. We compared patients who underwent revision IPP surgery and subtotal device removal with “drain and retain” to those who had complete component removal and exchange. Explant cases for infection and revision cases using the original UPR were excluded. Postoperative complications and infection rates were evaluated and compared to patients receiving primary IPP surgery as a control group. Results 1201 primary IPP cases and 231 revision cases were included. Among the revision cases, 112 (48.5%) utilized the "drain and retain" technique, while 119 (51.5%) involved complete reservoir removal. Patient demographics are listed in Table 1. There were no statistically significant differences in postoperative infection rates (p = 0.897) among the groups (Table 2). Similarly, there were no statistically significant differences in postoperative infections when stratified by different prosthesis types (p = 0.987). Regarding non-infections complications, there were no significant differences between the “drain and retain” group compared to revision cases where all components were removed. (p = 0.393) (Table 3). Conclusions To our knowledge, this is the most extensive study assessing the safety of leaving UPR in place during IPP revision surgery. The "drain and retain" strategy is a safe approach for IPP revision surgery. It avoids the potential morbidity of dissection into the retropubic space while maintaining infection and complication rates comparable to primary IPP cases. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Boston Scientific; Coloplast; BK Ultrasound.