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Scrotal Abscess Precipitating Late Infection of a Malleable Penile Prosthesis: The Risk Never Evanesces
Osama Mustafa1, Sultan Althakafi2, Said Kattan3
1College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
Abstract:
Although infrequent, infections represent the dreadful complication of penile prosthesis implantation. The incidence substantially decreases after a few infection-free postoperative months. We report herein a case of a very late penile prosthesis infection from a fistualizing scrotal abscess in a 67-year-old man. The patient presented with a one-month history of persistent penile-base discharge from a right hemiscrotal swelling. On examination, mild penile tenderness and a discharging penoscrotal-junction sinus were noted. Microbiological wound culture was positive for Staphylococcus epidermidis. Magnetic resonance imaging revealed this multiloculated fluid collection's communication with the right corporal body. Removal of the prosthesis was performed. Pathological evaluation of the dissected fistula was suggestive of acute on top of chronic inflammatory reactions. To our knowledge, this is the first report of a scrotal abscess leading to penile prosthesis infection 15 years after an uneventful implantation.
Insights
A rare, very late penile prosthesis infection occurred 15 years post-implantation due to a scrotal abscess. This case highlights the potential for delayed complications from penile implants.
Area of Science:
- Urology
- Infectious Diseases
- Medical Device Complications
Background:
- Penile prosthesis implantation is associated with infrequent infections, typically occurring early postoperatively.
- Late infections are rare but can be severe complications of penile implants.
Purpose of the Study:
- To report a unique case of a very late penile prosthesis infection.
- To describe the presentation and management of a penile prosthesis infection originating from a scrotal abscess.
Main Methods:
- Case report of a 67-year-old male patient with a late-onset penile prosthesis infection.
- Clinical examination, microbiological wound culture (Staphylococcus epidermidis), and magnetic resonance imaging (MRI) were utilized.
- Surgical intervention involving prosthesis removal and pathological evaluation of the fistula.
Main Results:
- A 67-year-old male presented with a scrotal abscess and discharge 15 years after uneventful penile prosthesis implantation.
- MRI confirmed communication between the scrotal abscess and the corporal body.
- Infection was attributed to Staphylococcus epidermidis; prosthesis removal was performed.
Conclusions:
- This is the first reported case of penile prosthesis infection secondary to a scrotal abscess presenting 15 years after implantation.
- Very late infections, though rare, necessitate thorough investigation and management.
- Delayed complications underscore the importance of long-term monitoring for penile prosthesis recipients.
