Infection rates in primary inflatable penile prosthesis: a systematic review and meta-analysis of antibiotic-coated...

Our aim was to conduct a systematic review with meta-analysis comparing primary inflatable penile prosthesis with and without antibiotic coverage, determining infection rates and identifying the most effective prophylaxis to prevent infectious complications. We conducted a systematic search of the PubMed, EMBASE, MEDLINE, and LILACS databases. The search and selection process followed PRISMA guidelines, and the selected studies were evaluated for quality using the ROBINS-I tool. Predefined inclusion and exclusion criteria were used to filter the results, and a meta-analysis was later performed using the R Statistical Software. After removing duplicate studies, 50 studies were selected for full-text analysis, and 29 were included for further examination. Of those, 11 observational studies comprising 102,572 patients who underwent primary penile prosthesis implantation, with or without antibiotic-coated or non-coated prostheses, were included in the meta-analysis. Our analysis revealed a significant decline in infection rates among those using coated prostheses (HR = 0.38; CI 0.28 to 0.51; p < 0.01; I² = 85.5%). We also meta-analyzed studies comparing the two major prosthesis brands on the market, Boston Scientific and Coloplast, and found no difference in infection rates between them (HR = 1.02; CI 0.17 to 6.02; p = 0.98; I² = 88.7%). Antibiotic-coated inflatable penile prosthesis demonstrated a significant decline in infection rates compared to non-coated devices. These findings are based on observational studies, and further research is warranted to better understand the role of different prophylaxis strategies in preventing infections.