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Penile prosthesis infections
D K Montague1, K W Angermeier, M M Lakin
1Urological Institute, Cleveland Clinic Foundation, Ohio 44195, USA. montagd@ccf.org
Abstract:
In this retrospective review we looked at infection rates and risk factors in penile prosthesis recipients. Computer registry records of patients implanted with three-piece inflatable prostheses from April 1986 to March 1999 were reviewed. Bacteriological culture report data were obtained from the medical records. There were 491 three-piece inflatable penile prosthesis recipients with follow-up ranging from 1 to 168 months (mean 83). All patients were implanted more than 1 y ago. There were 10 infections in 491 recipients (2.0%). In 285 primary prosthesis recipients there were seven infections (2.5%). In 206 secondary prosthesis recipients there were three infections (1.5%). Seven infections occurred in 354 non-diabetics (2.0%) and three infections occurred in 137 diabetics (2.2%). None of these differences were statistically significant. Explants for infection were performed in 8 weeks or less following implantation in eight patients. In two patients explants occurred at 17 and 26 months following implantation. Cultures from the periprosthetic space grew E. coli (four), Proteus mirabilis (two), Staph. aureus (two), and bacteroides (two). Infections occurred in 2.0% of three-piece inflatable penile prosthesis recipients. There were no statistically significant differences in infection rates between first time and repeat prosthesis recipients and between diabetic and non-diabetic recipients. Eight of the 10 infections occurred 8 weeks or less following implantation.
Insights
Penile prosthesis infection rates were 2.0% in this review of inflatable penile prostheses. Risk factors like diabetes or repeat surgery did not significantly alter infection rates, with most infections occurring early.
Area of Science:
- Urology
- Infectious Disease
Background:
- Penile prostheses are implanted to treat erectile dysfunction.
- Infection is a significant complication following penile prosthesis implantation.
Purpose of the Study:
- To determine infection rates and identify risk factors in recipients of three-piece inflatable penile prostheses.
- To analyze the timing and common pathogens associated with penile prosthesis infections.
Main Methods:
- Retrospective review of computer registry records for 491 patients who received three-piece inflatable penile prostheses between April 1986 and March 1999.
- Analysis of bacteriological culture reports from medical records to identify causative organisms.
- Comparison of infection rates between primary and secondary recipients, and between diabetic and non-diabetic patients.
Main Results:
- Overall infection rate was 2.0% (10 out of 491 recipients).
- Infection rates were similar for primary (2.5%) and secondary (1.5%) recipients, and for non-diabetic (2.0%) and diabetic (2.2%) patients; these differences were not statistically significant.
- Eight of the ten infections occurred within 8 weeks of implantation.
- Commonly cultured organisms included E. coli, Proteus mirabilis, Staph. aureus, and Bacteroides.
Conclusions:
- The infection rate for three-piece inflatable penile prostheses is low at 2.0%.
- Diabetes and prior prosthesis implantation are not significant risk factors for infection.
- Early detection and intervention are crucial, as most infections manifest within 8 weeks post-implantation.