PD3-11 CAN IT WAIT? – A SYSTEMATIC REVIEW OF IMMEDIATE VERSUS DELAYED SURGICAL REPAIR OF PENILE FRACTURE

You have accessJournal of UrologyTrauma/Reconstruction: Trauma & Reconstructive Surgery I1 Apr 2014PD3-11 CAN IT WAIT? – A SYSTEMATIC REVIEW OF IMMEDIATE VERSUS DELAYED SURGICAL REPAIR OF PENILE FRACTURE Nathan Wong, Shawn Dason, Rahul Bansal, Timothy Davies, and Luis Braga Nathan WongNathan Wong More articles by this author , Shawn DasonShawn Dason More articles by this author , Rahul BansalRahul Bansal More articles by this author , Timothy DaviesTimothy Davies More articles by this author , and Luis BragaLuis Braga More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.156AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Penile fractures have classically been thought to require immediate surgical intervention, but a number of recent series have described acceptable outcomes with delayed repair. Optimal time to surgical management of penile fractures is unclear and is examined in this systematic review. METHODS A systematic search of MEDLINE, Embase, CENTRAL as well as conference abstracts via Web of Science was performed with predefined search terms. Eligibility criteria included: i) diagnosis of penile fracture, ii) comparative study design with immediate and delayed repair groups iii) measurable surgical outcomes, and iv) 2 or more patients in each study group. Titles and abstracts were screened for eligibility criteria prior to full text review and abstraction by two independent authors, and discrepancies were arbitrated by a third author. Abstracted data fields were defined a priori and outcomes included rates of postoperative erectile dysfunction (ED), penile curvature and penile plaques. Quality appraisal was performed with a proprietary adapted scale. Studies reporting rates of ED and using an immediate versus delayed definition of <24 hours and >24 hours to repair respectively were included in meta-analysis using a random effects Mantel-Haenszel odds ratio method and 0.5 zero-cell correction. RESULTS A total of 669 citations were retrieved, of which 13 studies met inclusion criteria (533 patients). All series were retrospective observational studies appraised to be of low quality. Of the reported patients, 398 underwent immediate repair and 135 underwent delayed repair. The mean patient age among studies ranged from 27.0 to 41.6 years. Delayed groups had a mean time to repair ranging from 29.3 hours to 16 days. In the immediate group, the number of patients having ED, curvature, and plaque were 26, 9 and 22 respectively. In the delayed group, ED, curvature and plaque were reported in 8, 11 and 6 patients respectively. Ten studies were eligible for meta-analysis (Figure 1). The rate of ED following immediate repair compared to delayed repair did not differ significantly [OR 0.645, 95% CI 0.261-1.592, p=0.341]. CONCLUSIONS Rates of ED or other complications did not differ between delayed and immediate repair of penile fractures. Delayed repair of penile fractures may be a reasonable alternative to immediate surgery. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e23-e24 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Nathan Wong More articles by this author Shawn Dason More articles by this author Rahul Bansal More articles by this author Timothy Davies More articles by this author Luis Braga More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...