Prosthetic penile infection: "rescue procedure" with rifamycin
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C Teloken1, J C Souto, C Da Ros
1Department of Urology, Irmandade Santa Casa de Misericordia, Porto Alegre, Brazil.
Abstract:
Penile prosthetic implantation is a successful procedure for the management of male erectile impotence. However, infection remains the most serious complication requiring removal of the device. Later reinsertion can be difficult due to fibrosis and a shortened penis. We present 3 cases of penile infection with Staphylococcus epidermidis in which a new penile prosthesis was placed after 72 hours of continuous irrigation of the corpora cavernosa with rifamycin. The procedure requires judicious selection of patients and a stable clinical status.
Insights
Infection after penile prosthesis surgery can be serious. This study shows continuous irrigation with rifampin successfully treated three cases of Staphylococcus epidermidis infection, allowing for new device placement.
Area of Science:
- Urology
- Infectious Diseases
- Biomaterials Science
Background:
- Penile prosthetic implantation is a standard treatment for erectile dysfunction.
- Infection is a significant complication, often necessitating device removal and complicating future reimplantation due to penile fibrosis.
- Staphylococcus epidermidis is a common pathogen in prosthetic infections.
Purpose of the Study:
- To evaluate the efficacy of continuous irrigation with rifampin in treating penile prosthesis infections caused by Staphylococcus epidermidis.
- To assess the feasibility of reinserting a new penile prosthesis after infection treatment.
Main Methods:
- Three patients with penile prosthesis infection due to Staphylococcus epidermidis were treated.
- Continuous irrigation of the corpora cavernosa with rifampin for 72 hours was performed.
- A new penile prosthesis was subsequently implanted in all three patients.
Main Results:
- Successful resolution of Staphylococcus epidermidis infection in all three cases.
- Successful reinsertion of penile prostheses after the irrigation protocol.
- No significant complications reported during or after the irrigation and reinsertion procedures.
Conclusions:
- Continuous 72-hour irrigation of the corpora cavernosa with rifampin is an effective method for treating penile prosthesis infections.
- This approach facilitates successful reinsertion of penile prostheses, overcoming challenges posed by infection and fibrosis.
- Careful patient selection and stable clinical status are crucial for this treatment strategy.