Postoperative management after penile fracture surgery: Intraoperative drainage is not associated with early morbidity reduction after penile fracture repair (FRACT AFUF project).
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
De Brek Norbert, Peyrottes Arthur, Dariane Charles, Pattou Maxime, Clerget Alexandra, Desgrandchamps François, Sabbagh Paul, Dupuis Hugo, Duffaut Louise, Duquesne Igor, Mesnard Benoît, Miquel Capucine, Lorette Martin, Delchet Ophélie, Boileau Adrien, Levy Stéphan, Bourillon Alice, Goujon Anna, Lethuillier Valentine, Faix Antoine, Mathez William, Tissot Gabrielle, De La Taille Alexandre, Mardelli Céline, Papin Grégory, Galano Arthur, Waeckel Thibaut, Bacle Charly, Schirmann Aurélie, Chauveau Élodie, Eschwege Pascal, Gardet Jefferson, De Sousa Philippe, Reichenbach Angèle, Neuville Paul, Chabenes Maxime, Fiard Gaelle, Bessede Thomas, Lebacle Cédric
Аннотация
METHODS: We performed a retrospective multicenter study including all patients with surgically confirmed corpus cavernosum fracture between 2000 and 2024 across 21 French centers. Patients were stratified according to intraoperative drain placement. The primary outcome was any early postoperative complication within 30days (hematoma, surgical-site infection, wound dehiscence, painful edema, skin necrosis, or urinary retention). The key secondary outcome was a focused surgical-site composite (hematoma, surgical-site infection, or wound dehiscence). Hospital stay and symptoms at 1 and 3months were also evaluated. Multivariable logistic regression adjusted for surgical approach, urethral or bilateral injury and surgeon experience assessed associations with complications.
RESULTS: Among 457 patients, 153 (34%) received a drain. Drain placement was associated with longer operative time and hospital stay and more frequent degloving approach. The overall postoperative complication rate was 11%. Drain placement was not significantly associated with complications (OR: 1.18; 95% CI: 0.59-2.29; P=0.63), whereas urethral injury was (OR: 2.33; 95% CI: 1.06-4.91, P=0.03). At 1month, 63% of patients reported at least one symptom and sexual pain was more frequent in the drain group (25% vs. 18%; P=0.04). Interpretation is limited by retrospective design and loss to follow-up.
CONCLUSION: Intraoperative drainage was not associated with reduced early morbidity and was associated with a longer hospital stay and more sexual pain at 1month. Although these findings do not support the routine use of drains after penile fracture repair, our study does not exclude a potential benefit in selected complex cases. Drain use should therefore be tailored to intraoperative findings.
LEVEL OF EVIDENCE: IV.