Practice patterns of Canadian penile prosthesis implanters
Bibliographic record
Abstract
INTRODUCTION: Penile prosthesis implantation is a well-established treatment for refractory erectile dysfunction; however, significant variations exist in surgical techniques and practice patterns, often influenced by individual surgeon experience and training. Our study aimed to identify these variations among Canadian implanters, assessing their approach to penile prosthesis surgery. METHODS: A cross-sectional, questionnaire-based study was conducted to evaluate the practice patterns of Canadian surgeons performing penile prosthesis implantation. The study included implanters from all provinces who perform more than five cases annually. An anonymous electronic survey was distributed, assessing practice patterns, surgical approach, and recommendations for improving penile prosthesis surgery in Canada. RESULTS: Seventeen Canadian urologists performing over five annual cases participated in the study, with the annual volume varying among respondents. The majority (88.2%, n=15) routinely checked HbA1c levels, with 54.5% (n=6) using a cutoff of 8%. Additionally, 58.8% (n=10) routinely ordered a urine culture, and 94.1% (n=16) performed a preoperative scrub. Just over half (52.9%, n=9) prescribed preoperative antibiotics, the majority (88.2%, n=15) used an antibiotic dip, and postoperatively, 94.1% (n=16) of respondents prescribed antibiotics. Most implanters (76.5%, n=13) primarily used a penoscrotal approach, and 47.1% (n=8) did not routinely place a drain. Respondents also indicated perceived ways to improve penile prosthesis education across Canada, focusing on patient education and surgical simulation. CONCLUSIONS: While key aspects, such as the ideal surgical approach, HbA1c cutoffs, antibiotic regimens, and intraoperative techniques, remain debated, our findings underscore the need for further standardization. High-quality educational resources and consensus guidelines could help implanters refine their practice and improve patient outcomes.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".