Klein Roger, Huang Sherry, Myrga John, Daly William, Rusilko Paul
Department of Urology, University of Pittsburgh Medical Center, Pittsburgh, PA, 15213, USA.
Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, 15213, USA.
World J Urol. 2025 May 6;43(1):276. doi: 10.1007/s00345-025-05559-8.
Optimization of preoperative counselling and postoperative care pathways to maximize patient satisfaction and healthcare system efficiency requires an understanding of healthcare system interactions that result from postoperative patient concerns. We sought to identify patterns of healthcare utilization following inflatable penile prosthesis (IPP) placement in patients managed with a single scheduled postoperative appointment.
A single-center retrospective chart review of 190 patients undergoing IPP placement or three-component revision was performed. Demographic information, intraoperative findings, and immediate postoperative variables were obtained. The timing and primary reason for unplanned postoperative office visits, phone calls/electronic messages, and emergency department visits were recorded for each patient.
65 patients (34%) presented for an unplanned office visit within 90 days of surgery, with 11% requiring multiple visits. Common concerns included the appearance of the surgical site (39%), device appearance or function (38%), and pain (14%). Discharge with an opioid prescription was associated with an increased incidence of unscheduled postoperative visits. 58% of patients contacted the surgical office via phone or electronic health record. Common reasons for communication were clarification of postoperative instructions (24%), device concerns (23%), and pain (21%). Prior penile prosthesis surgery was associated with a decreased rate of communication. Discharge timing and a history of a chronic pain or psychiatric condition did not affect postoperative healthcare system engagement.
While phone calls and messages following penile prosthesis placement are common, most patients can be managed with a single postoperative appointment.
优化术前咨询和术后护理路径以最大限度提高患者满意度和医疗系统效率，需要了解术后患者担忧所导致的医疗系统相互作用。我们试图确定在安排单次术后预约的患者中，植入可膨胀阴茎假体（IPP）后的医疗利用模式。
对190例行IPP植入或三部件翻修术的患者进行单中心回顾性病历审查。获取人口统计学信息、术中发现及术后即刻变量。记录每位患者计划外术后门诊就诊、电话/电子信息及急诊就诊的时间和主要原因。
65例患者（34%）在术后90天内进行了计划外门诊就诊，其中11%需要多次就诊。常见担忧包括手术部位外观（39%）、装置外观或功能（38%）以及疼痛（14%）。开具阿片类药物处方出院与计划外术后就诊发生率增加相关。58%的患者通过电话或电子健康记录联系手术科室。沟通的常见原因是术后指导的澄清（24%）、装置相关问题（23%）和疼痛（21%）。既往阴茎假体手术与沟通率降低相关。出院时间以及慢性疼痛或精神疾病史不影响术后医疗系统参与情况。
虽然阴茎假体植入后打电话和发信息很常见，但大多数患者通过单次术后预约即可得到处理。
