(530) Blood Thinners: Does it Need to be Held for IPP Surgery?

Abstract Introduction Penile prosthesis placement in men on active anti-coagulation (AC) is controversial. The bleeding risk of continued blood thinners must be weighed against the increased thrombotic for patients when stopping them. Previously utilized techniques to decrease complication rates from AC include use a malleable implant only, leaving IPP partially inflated hemostasis, and drain. Objective We sought assess outcomes penile clopidogrel, warfarin, apixaban, enoxaparin, rivaroxaban multi-institutional study. Methods Data 3 high volume centers were retrospectively obtained. Demographic characteristics, comorbidities, case information including secondary procedures, drain, drain output, complications recorded. with aspirin any dose alone not included as all do routinely discontinue ASA at time implant. One center never placed drains used penoscrotal approach, one left least day removed output was < 50 ml/8 hours last days an infra-pubic approach. Results 202 throughout surgery. 112 35 38 1 15 rivaroxaban, combination therapy clopidogrel enoxaparin. requirement peripheral vascular disease (55%), CHF (11%), cardiac stents (11.6%), DVT/PE/history thrombosis (7%), atrial fibrillation valves (2.2%), stroke (1.3%), preventive (0.9%). Nine (3.98%) experienced 4 significant events (1.9%): major retropubic bleed requiring transfusion, infections 5 minor events: hematomas, wound dehiscence CT negative event. Drain outputs averaged 113 ml, 81 ml 30 per respectively total average 223 no hematomas nor infections. removal 121 majority or having only day. significantly higher than historical non controls (121 vs. 72 p=.001) but there difference hematoma rate. Three infection occurred this group. type, revision surgery, scrotoplasty, reservoir technique did affect drainage (P>.05). Complication rate (IPP rate) where different compared large cohorts respective institutions. Conclusions Our data shows 1.9% undergoing anticoagulation centers. Although approach appears feasible similar AC, careful consideration benefit ratio should undertaken. indicate closed suction draining may warranted. Additionally, argues submuscular reservoirs under direct vision which minimizes occult risk. In cases, elective surgery delayed until it safe therapy. Disclosure No