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Infection retardant coated inflatable penile prostheses decrease the incidence of infection: a systematic review and
Sree Harsha Mandava1, Ege Can Serefoglu, Matthew T Freier
1Department of Urology, Tulane University, New Orleans, Louisiana 70112, USA.
Purpose:
This systematic review was done to compare the effectiveness of infection retardant coated inflatable penile prostheses vs noncoated devices.
Materials And Methods:
We systematically reviewed PubMed® and Galileo® to identify all relevant case studies. The postoperative infection incidence rate was compared for coated and noncoated inflatable penile prostheses to determine whether coating the implant affects the rate of surgical implant infection.
Results:
Included in analysis were 14 clinical case studies in a total of 9,910 patients with a first time implant, including 5,214 inflatable penile prostheses without an infection retardant coating and 4,696 coated inflatable penile prostheses impregnated with minocycline/rifampin (3,158), rifampin/gentamycin immersion (181), vancomycin/gentamycin immersion (181) and a hydrophilic coating only (1,176). For noncoated vs coated prostheses the infection rate was 2.32% vs 0.89% (p <0.01), including 0.63%, 0.55%, 4.42% and 1.11% for minocycline/rifampin, rifampin/gentamycin immersion, vancomycin/gentamycin immersion and hydrophilic coatings, respectively.
Conclusions:
This analysis documents a significant advantage of using coated compared to noncoated inflatable penile prostheses to prevent postoperative device infection. Infection retardant coatings that allow antibiotics to elute off the device components decrease the incidence of device infection by approximately 50%. Future studies must address novel techniques, such as preventing bacterial adhesion, to further decrease infectious etiologies.
Insights
Infection retardant coated inflatable penile prostheses significantly reduce device infection rates compared to noncoated devices. This finding highlights the benefit of antibiotic-eluting coatings in preventing surgical implant infections.
Area of Science:
- Urology
- Infectious Disease
- Biomaterials Science
Background:
- Postoperative infections are a significant complication following inflatable penile prosthesis (IPP) implantation.
- Reducing the incidence of surgical site infections (SSIs) is crucial for improving patient outcomes and device longevity.
Purpose of the Study:
- To systematically compare the effectiveness of infection retardant coated IPPs versus noncoated devices in preventing postoperative infections.
- To determine if implant coatings impact the rate of surgical implant infection.
Main Methods:
- A systematic review of PubMed and Galileo databases was conducted to identify relevant case studies.
- Postoperative infection incidence rates were compared between coated and noncoated IPPs.
Main Results:
- Analysis included 14 case studies with 9,910 patients; 5,214 noncoated and 4,696 coated IPPs.
- Infection rates were 2.32% for noncoated vs. 0.89% for coated IPPs (p <0.01).
- Specific coated IPPs showed varying infection rates: minocycline/rifampin (0.63%), rifampin/gentamycin (0.55%), vancomycin/gentamycin (4.42%), and hydrophilic (1.11%).
Conclusions:
- Coated IPPs offer a significant advantage in preventing postoperative device infections compared to noncoated devices.
- Antibiotic-eluting coatings reduce device infection incidence by approximately 50%.
- Future research should explore novel techniques, such as preventing bacterial adhesion, to further minimize infectious complications.
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