Shaeer Osama, Elahwany Amr, El Debs Hossam, Ragheb Ahmed, Shaeer Kamal O K M, Shaeer Kamal
Department of Andrology, Kasr El Aini Faculty of Medicine, Cairo University, Giza, Egypt.
Department of Urology, Beni-Suef Faculty of Medicine, Beni-Suef, Egypt.
Int J Impot Res. 2025 Oct 23. doi: 10.1038/s41443-025-01184-6.
Hematoma formation is one of the complications of inflatable penile prosthesis implantation (iPP), possibly indicating surgical evacuation, or resulting in infection and removal of the implant. Gelatin Sponge (Gelfoam®, Pfizer, USA) is sterile compressed sponge, used as a hemostatic agent, directly applied to bleeding surfaces. It is water insoluble, but absorbable within 4-6 weeks with minimal scar formation. In this study, we evaluate the use of Gelfoam® for control of hemostasis and minimizing post-operative bleeding in iPP surgery. Fifty-eight patients were enrolled into one of two groups according to their will, documented in the consent form: the Gelatin Sponge (GS) group (n = 22), and the control group (n = 36). Following cylinder insertion, corporotomies were closed by tying the stay sutures. For the GS group, Gelfoam® was applied to the closed corporotomies, pump space and reservoir track. A closed suction drain was inserted for all cases and monitored post-operatively. Mummy wrap was not used to evaluate Gelfoam® independently. Patients were monitored for drain output and complications. The mean drain output was significantly higher in the control group compared to GS group, both for the first 24 h (156.7 cc ± 91.6 cc vs. 45.9 cc ± 36.9 cc, 70.7% difference, p < 0.0001) and 24-48 h (40.7 cc ± 42.4cc vs. 8.6 cc ± 12.6 cc, 78.8% difference, p < 0.0001). No cases of hematoma formation, infection, foreign body reaction, mass formation or hypersensitivity reaction were encountered in the GS group, compared to two cases of hematoma in the control group, one of which dictated drainage (2/36). The findings herein demonstrate the safety and tolerability of Gelfoam® in iPP surgery, as well as its efficacy in minimizing post-operative bleeding.
血肿形成是可膨胀阴茎假体植入术（iPP）的并发症之一，可能需要手术清除，否则会导致感染并移除植入物。明胶海绵（Gelfoam®，辉瑞公司，美国）是一种无菌压缩海绵，用作止血剂，直接应用于出血表面。它不溶于水，但在4 - 6周内可吸收，形成的瘢痕极小。在本研究中，我们评估了Gelfoam®在iPP手术中控制止血和减少术后出血的应用。58名患者根据其意愿被纳入两个组之一，并记录在同意书中：明胶海绵（GS）组（n = 22）和对照组（n = 36）。插入圆柱体后，通过系紧牵引缝线关闭阴茎海绵体切口。对于GS组，将Gelfoam®应用于关闭的阴茎海绵体切口、泵腔和贮液囊通道。所有病例均插入闭式引流管并在术后进行监测。未使用阴茎包扎来单独评估Gelfoam®。对患者的引流液量和并发症进行监测。对照组在前24小时（156.7 cc±91.6 cc对45.9 cc±36.9 cc，差异70.7%，p < 0.0001）和24 - 48小时（40.7 cc±42.4 cc对8.6 cc±12.6 cc，差异78.8%，p < 0.0001）的平均引流液量均显著高于GS组。GS组未出现血肿形成、感染、异物反应、肿块形成或过敏反应病例，而对照组有2例血肿，其中1例需要引流（2/36）。本研究结果证明了Gelfoam®在iPP手术中的安全性和耐受性，以及其在减少术后出血方面的有效性。
