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Placement of penile prosthesis had been well described in the outpatient setting, however, one barrier to same-day discharge is postoperative urinary retention (POUR). POUR remains a condition encountered during ambulatory surgical procedures and has yet to be characterized in patients undergoing penile prosthesis. We characterized POUR in a cohort of penile prosthesis recipients along with risk factors and management. Patients undergoing penile prosthesis implantation from 2014 through 2020 without pre-existing retention were included. All patients underwent a void trial immediately following penile prosthesis in the post-anesthesia care unit. POUR was strictly defined as (1) any patient requiring catheter replacement after prosthesis, (2) a rising post-void residual, or (3) inability to void after 6 h regardless of whether a catheter was placed. Independent procedures, demographic, intraoperative, and postoperative risk factors for POUR were assessed. 317 men were included of whom 27.1% experienced POUR. Men experiencing POUR and those not in retention were essentially indistinguishable with respect to previously described risk factors for POUR. Only use of both α-blockers and 5-α-reductase inhibitors was significantly associated with a greater risk of POUR, a finding maintained on adjusted analysis (adjusted odds ratio 10.1, 95% confidence interval 2.1 to 49.8). POUR resolved without intervention in 3.5%, a single episode of clean intermittent catheterization (CIC) in 7.0% of patients, and repeated CIC or indwelling catheter placement with a successful delayed void trial in 88.4% of patients. Rate of prosthesis infection in patients who experienced POUR did not significantly differ from those who did not experience POUR (4.7% vs. 2.2% p = 0.26). Our findings suggest that POUR is experienced in as many as 1 in 4 men undergoing penile prosthesis placement, most of whom must be managed with indwelling catheterization or repeated CIC. Those with indicators of symptomatic prostate enlargement are at significantly greater risk of urinary retention., (© 2022. The Author(s), under exclusive licence to Springer Nature Limited.)

Objective: To compare perioperative and oncologic outcomes of intracorporeal (ICNB) and extracorporeal neobladder (ECNB) following robot assisted radical cystectomy (RARC) from a multi-institutional, prospectively maintained database, the International Robotic Cystectomy Consortium (IRCC)., Methods: A retrospective review of IRCC database between 2003 and 2020 (3742 patients from 33 institutions across 14 countries) was performed (I-79606). The Cochran-Armitage trend test was used to assess utilization of ICNB over time. Multivariate logistic regression models were fit to evaluate variables associated with receiving ICNB, overall complications, high-grade complications, and readmissions after RARC. Kaplan Meier curves were used to depict recurrence-free, disease-specific, and overall survival., Results: Four hundred eleven patients received neobladder, 64% underwent ICNB. ICNB utilization increased significantly over time (P <.01). Patients who received ICNB were readmitted and received neoadjuvant chemotherapy more frequently (36% vs 24%, P = .03, 35% vs 8%, P <.01, respectively). ICNB was associated with older age (OR 1.04, 95% CI 1.01-1.07, P = .001), receipt of neoadjuvant chemotherapy (OR 4.63, 95% CI 2.34-9.18, P <.01), and more recent RARC era (2016-2020) (OR 12.6, 95% CI 5.6-28.4, P <.01). On multivariate analysis, ICNB (OR 5.43, 95% CI 2.34-12.58, P <.01), positive surgical margin (OR 4.88, 95% CI 1.29-18.42, P = .019), longer operative times (OR 1.26, 95% CI 1.00-1.58, P = .048), and institutional annual RARC volume (OR 1.09, 95% CI 1.05-1.12, P <.01) were associated with readmissions., Conclusion: Utilization of ICNB increased significantly over time. Patients who underwent RARC and ICNB had shorter hospital stays and fewer 30-d reoperations but were readmitted more frequently compared to those who underwent ECNB., (Copyright © 2021 Elsevier Inc. All rights reserved.)