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Salvage penile prosthetic surgery utilizing temporary malleable implants.

Michael Lao1, R James Graydon2, Jared M Bieniek2

  • 1Department of Urology, University of Connecticut Health Center, Farmington, CT, USA.

Translational Andrology and Urology
|December 15, 2017
PubMed
Summary

Inflatable penile prosthesis (IPP) infection is a complication of erectile dysfunction (ED) treatment. Malleable implants used in salvage procedures are effective for infection eradication and preventing fibrosis.

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Area of Science:

  • Urology
  • Medical Devices
  • Surgical Outcomes

Background:

  • Infection remains a serious complication of inflatable penile prosthesis (IPP) surgery for erectile dysfunction (ED).
  • Traditional management involves hardware removal, irrigation, and often a subsequent implant to prevent corporal fibrosis.
  • Salvage procedures aim to eradicate infection while preserving the possibility of future implantation.

Purpose of the Study:

  • To review the literature on immediate salvage procedures for infected penile prostheses.
  • To compare the efficacy of traditional IPP reimplantation versus malleable device salvage procedures in managing prosthetic infections.
  • To evaluate the role of malleable implants as temporary or definitive solutions in salvage scenarios.

Main Methods:

  • Literature review of studies on immediate salvage procedures for infected penile prostheses.
Keywords:
Erectile dysfunction (ED)infectionpenile prosthesispostoperative complicationsalvage therapy

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  • Analysis of outcomes from typical Mulcahy washout and IPP reimplantation.
  • Examination of case series and multicenter trials using malleable devices in salvage procedures.

    • Main Results:

    • Management with Mulcahy washout and IPP reimplant can be successful in selected patients.
    • Using malleable devices as temporary implants in salvage procedures demonstrates similar or greater success in eradicating infection.
    • Malleable implants effectively prevent corporal fibrosis and may serve as adequate long-term therapy for some patients.

    Conclusions:

    • Immediate salvage with malleable penile prostheses is a viable and effective strategy for managing infected implants.
    • Malleable devices offer benefits in preventing fibrosis and may reduce the need for subsequent inflatable prosthesis conversion.
    • Further research is required to fully understand patient satisfaction and optimize the role of malleable devices in penile prosthesis salvage.