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Related Experiment Videos

Penile prosthesis cultures during revision surgery: a multicenter study.

Gerard D Henry1, Steven K Wilson, John R Delk

  • 1Institute for Urologic Excellence, Van Buren, Arkansas, USA. GDHenry@hotmail.com

The Journal of Urology
|June 18, 2004
PubMed
Summary

Revision surgery for penile implants reveals a high rate of bacterial presence, even in uninfected devices. Most bacteria are Staphylococcus species, sensitive to rifampin and minocycline, suggesting potential for antibiotic-coated implants.

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Area of Science:

  • Urology
  • Infectious Disease
  • Biomedical Engineering

Background:

  • Infection is a significant complication of penile prosthesis implantation, with higher rates during revision surgeries (10-18%) compared to initial procedures (3%).
  • The reasons for increased infection risk in revision cases are not fully understood.
  • Prosthesis pain is being investigated as a potential indicator of subclinical infection.

Purpose of the Study:

  • To investigate the prevalence of bacterial colonization in clinically uninfected penile prostheses during revision surgery.
  • To identify the types of bacteria present and their antibiotic sensitivities.
  • To assess if prosthesis pain predicts positive bacterial cultures.

Main Methods:

  • Prospective study involving cultures from 77 clinically uninfected penile prostheses during revision surgery at three institutions.

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  • Cultures were obtained from the pump and any visible biofilms.
  • Bacterial isolates, particularly Staphylococcus species, were tested for sensitivity to rifampin and tetracycline (minocycline).

    • Main Results:

    • Bacterial growth was detected in 70% (54/77) of clinically uninfected prostheses.
    • Staphylococcus species were identified in 90% (49/54) of positive cultures, with 10 different species identified.
    • All staphylococcal isolates showed sensitivity to rifampin and/or tetracycline.
    • No significant association was found between chronic prosthesis pain and positive culture results.

    Conclusions:

    • A high percentage of penile prostheses undergoing revision surgery harbor bacteria, even without overt signs of infection.
    • Staphylococcus species are the predominant bacteria found and are susceptible to rifampin and minocycline.
    • These findings support the use of antibiotic-coated implants to reduce infection risk in revision penile prosthesis surgery.