Penile Prosthesis Infection: Approaches to Prevention and Treatment

Urologic Clinics of North America

Volumn 38, Issue 2, 2011, Pages 227-235

  Selph, J Patrick ^a   Carson, Culley C ^a  

^a UNIVERSITY OF NORTH CAROLINA SCHOOL OF MEDICINE   (United States)

Author keywords

Infection; Penile prosthesis; Prevention; Treatment

Indexed keywords

ALCOHOL; AMINOGLYCOSIDE ANTIBIOTIC AGENT; ANTIBIOTIC AGENT; ANTIINFECTIVE AGENT; BACITRACIN; CEFALEXIN; CEPHALOSPORIN DERIVATIVE; CHLORHEXIDINE; CIPROFLOXACIN; GENTAMICIN; HYDROGEN PEROXIDE; KANAMYCIN; METICILLIN; POVIDONE IODINE; PSEUDOMONIC ACID; RIFAMPICIN; VANCOMYCIN;

BACTERIUM CULTURE; DIABETES MELLITUS; ENTEROCOCCUS; ESCHERICHIA COLI; HIGH RISK PATIENT; HOST PATHOGEN INTERACTION; HUMAN; IMPLANTATION; INCISION; INFECTION PREVENTION; INFECTION RISK; METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS; NONHUMAN; PATIENT CARE PLANNING; PENIS PROSTHESIS; PLASTIC SURGERY; PRIORITY JOURNAL; PROSTHESIS INFECTION; PROTEUS MIRABILIS; PSEUDOMONAS AERUGINOSA; REOPERATION; REVIEW; RISK FACTOR; RISK REDUCTION; SERRATIA MARCESCENS; SPINAL CORD INJURY; STAPHYLOCOCCUS EPIDERMIDIS; SURGICAL INFECTION; SURGICAL WOUND; TREATMENT FAILURE; UROLOGIC SURGERY; WOUND HEALING IMPAIRMENT;

ANTI-BACTERIAL AGENTS; EQUIPMENT CONTAMINATION; ERECTILE DYSFUNCTION; HUMANS; INTRAOPERATIVE CARE; MALE; PENILE PROSTHESIS; PREOPERATIVE CARE; PROSTHESIS DESIGN; PROSTHESIS-RELATED INFECTIONS; RISK FACTORS;

EID: 79957444409     PISSN: 00940143     EISSN: 1558318X     Source Type: Journal    
DOI: 10.1016/j.ucl.2011.02.007     Document Type: Review

References (84)

1. Feldman H.A., Goldstein I., Hatzichristou D.G., et al. Impotence and its medical and psychosocial correlates: results of the Massachusetts male aging study. J Urol 1994, 151:54.
2. Johannes C.B., Araujo A.B., Feldman H.A., et al. Incidence of erectile dysfunction in men 40 to 69 years old: longitudinal results from the Massachusetts male aging study. J Urol 2000, 163:2.
3. Darouiche R.O. Device-associated infections: a macroproblem that starts with microadherence. Clin Infect Dis 2001, 33(9):1567-1572.
4. Scott F.B., Bradley W.E., Timm G.W. Management of erectile impotence: use of implantable inflatable prosthesis. Urology 1973, 2:80.
5. Jhaveri F., Rutledge R., Carson C. Penile prosthesis implantation surgery: a statewide population based analysis of 2354 patients. Int J Impot Res 1998, 10(4):251.
6. Henry G.D., Wilson S.K. Updates in inflatable penile prostheses. Urol Clin North Am 2007, 34:535-547.
7. Carson C.C., Mulcahy J.J., Govier F.E. Efficacy, saftety and patient satisfaction outcomes of the AMS 700 CX inflatable penile prosthesis: results of a long term multicenter study. AMS 700 CX study group. J Urol 2000, 164:376-380.
8. Wilson S.K., Delk J.R., Salem E.A., et al. Long-Term survival of inflatable penile prostheses: single surgical group experience with 2,384 first-time implants spanning two decades. J Sex Med 2007, 4:1074-1079.
9. Montague D.K., Angermeier K.W. Contemporary aspects of penile prosthesis implantation. Urol Int 2003, 70(2):141-146.
10. Montorsi F., Rigatti P., Carmignani G., et al. AMS three-piece inflatable implants for erectile dysfunction: a long-term multi-institutional study in 200 consecutive patients. Eur Urol 2000, 37(1):50-55.
11. Dhar N.B., Angermeier K.W., Montague D.K. Long-term mechanical reliability of AMS 700CX/CXM inflatable penile prosthesis. J Urol 2006, 176(6 Pt 1):2599-2601.
12. Kim D.S., Yang K.M., Chung H.J., et al. AMS 700CX/CXM inflatable penile prosthesis has high mechanical reliability at long-term follow-up. J Sex Med 2010 Jul, 7(7):2602-2607.
13. Mulcahy J.J. Penile implant infections: prevention and treatment. Curr Urol Rep 2008, 9(6):487-491.
14. Jarow J.P. Risk factors for penile prosthesis infection. J Urol 1996, 156:402-404.
15. Quesada E.T., Light J.K. The AMS 700 inflatable penile prosthesis: long-term experience with the controlled expansion cylinders. J Urol 1993, 149(1):46-48.
16. Wilson S.K., Delk J.R. Inflatable penile implant infection: predisposing factors and treatment suggestions. J Urol 1995, 153:659-661.
17. Thomalla J.V., Thompson S.T., Rowland R.G., et al. Infectious complications of penile prosthetic implants. J Urol 1987, 138:65-67.
18. Lotan Y., Roehrborn C.G., McConnell J.D., et al. Factors influencing the outcomes of penile prosthesis surgery at a teaching institution. Urology 2003, 62:918-921.
19. Henry G.D., Wilson S.K., Delk J.R., et al. Penile prosthesis cultures during revision surgery: a multicenter study. J Urol 2004, 172:153-156.
20. Carson C.C. Infections in genitourinary prostheses. Urol Clin North Am 1989, 16:139.
21. Licht M.R., Montague D.K., Angermeier K.W., et al. Cultures from genitourinary prostheses at reoperation: questioning the role of Staphylococcus epidermidis in periprosthetic infection. J Urol 1995, 154:387.
22. Mulcahy J.J. Long-term experience with salvage of infected penile implants. J Urol 2000, 183:481-482.
23. Stewart P.S., Costerton J.W. Antibiotic resistance of bacteria in biofilms. Lancet 2001, 358(9276):135-138.
24. National Institutes of Health (NIDCR, NIAID) Targeted research on oral microbial biofilms (DE-98-006) Available at:, Accessed March 6, 1998. http://grants.nih.gov.libproxy.lib.unc.edu/grants/guide/rfa-files/RFA-DE-98-006.html.
25. Silverstein AD, Henry GD, Evans B, et al. Biofilm formation on clinically noninfected penile prostheses. J Urol 2006, 176(3):1008-1011.
26. Brant M.D., Ludlow J.K., Mulcahy J.J. The Prosthesis salvage operation: immediate replacement of the infected penile prosthesis. J Urol 1996, 155:155-157.
27. Knoll D.K. Penile prosthetic Infection: management by delayed and immediate salvage technique. Urology 1998, 52:287-290.
28. Costerton J.W., Montanaro L., Arciola C.R. Bacterial communications in implant infections: a target for an intelligence war. Int J Artif Organs 2007, 30(9):757-763.
29. Davies D.G., Marques C.N. A fatty acid messenger is responsible for inducing dispersion in microbial biofilms. J Bacteriol 2009, 191(5):1393-1403.
30. Fallon B., Ghanem H. Sexual performance and satisfaction with penile prostheses in impotence of various etiologies. Int J Impot Res 1990, 2:35-42.
31. Bishop J.U., Moul J.W., Sihelnik S.A., et al. Use of glycosylated hemoglobin to identify diabetics at high risk for penile periprosthetic infections. J Urol 1992, 147(2):386-388.
32. Wilson S.K., Carson C.C., Cleves M.A., et al. Quantifying risk of penile prosthesis infection with elevated glycosylated hemoglobin. J Urol 1998, 159:1537-1546.
33. Droggin D., Shabsigh R., Anastasiadis A.G. Antibiotic coating reduces penile prosthesis infection. J Sex Med 2005, 2:565-568.
34. Wilson S.K., Zumbe J., Henry G.D., et al. Infection reduction using antibiotic-coated inflatable penile prosthesis. J Urol 2007, 70:337-340.
35. Radomski S.B., Herschorn S. Risk factors associated with penile prosthesis infection. J Urol 1992, 147(2):383-385.
36. Collins K.P., Hackler R.H. Complications of penile prostheses in the spinal cord injury population. J Urol 1988, 140(5):984-985.
37. Golgi H. Experience with penile prosthesis in spinal cord injury patients. J Urol 1979 Mar, 121(3):288-289.
38. Rossier A.B., Fam B.A. Indication and results of semirigid penile prostheses in spinal cord injury patients: long-term followup. J Urol 1984, 131(1):59-62.
39. Dietzen C.J., Lloyd L.K. Complications of intracavernous injections and penile prostheses in spinal cord injured me. Arch Phys Med Rehabil 1992, 73(7):652-655.
40. Diokno A.C., Sonda L.P. Compatibility of genitourinary prostheses and intermittent self-catheterization. J Urol 1981, 125(5):659-660.
41. Sidi A.A., Peng W., Sanseau C., et al. Penile prosthesis surgery in the treatment of impotence in the immunosuppressed man. J Urol 1987, 137(4):681-682.
42. Cuellar D.C., Sklar G.N. Penile prosthesis in the organ transplant recipient. Urology 2001, 57(1):138-141.
43. Barry J.M. Treating erectile dysfunction in renal transplant recipients. Drugs 2007, 67(7):975-983.
44. Carson C.C., Robertson C.N. Late hematogenous infection of penile prostheses. J Urol 1988, 139(1):50-52.
45. Sausville J., Gupta G., Forrest G., et al. Salmonella infection of a penile prosthesis. J Sex Med 2009, 6(5):1487-1490.
46. Carson C.C., Noh C.H. Distal prosthesis extrusion: treatment with distal corporoplasty or Gortex windsock reinforcement. Int J Impot Res 2002, 14:81-84.
47. Kumar R., Nehra A. Dual implantation of penile and sphincter implants in the post-prostatectomy patient. Curr Urol Rep 2007, 8:477-481.
48. Sadeghi-Najed H. Penile prosthesis surgery: a review of prosthetic devices and associated complications. J Sex Med 2007, 4:296-309.
49. Fallon B., Ghanem H. Infection control in outpatient unicomponent penile prosthesis surgery. Int J Impot Res 1999, 11:25-27.
50. Mangram A.J., Horan T.C., Pearson M.L., et al. Guideline for prevention of surgical site infection, 1999. Centers for disease control and prevention infection control practices advisory committee. Am J Infect Control 1999, 27(2):97-132.
51. Rotter M.L., Larsen S.O., Cooke E.M., et al. A comparison of the effects of preoperative whole-body bathing with detergent alone and with detergent containing chlorhexidine gluconate on the frequency of wound infections after clean surgery. The European Working Party on Control of Hospital Infections. J Hosp Infect 1988, 11(4):310-320.
52. Leigh D.A., Stronge J.L., Marriner J., et al. Total body bathing with 'Hibiscrub' (chlorhexidine) in surgical patients: a controlled trial. J Hosp Infect 1983, 4(3):229-235.
53. Darouiche R.O., Wall M.J., Itani K.M., et al. Chlorhexidine-alcohol versus povidone-iodine for surgical-site antisepsis. N Eng J Med 2010, 362(1):18-26.
54. Noorani A, Rabey N, Walsh SR, et al. Systematic review and meta-analysis of preoperative antisepsis with chlorhexidine versus povidone-iodine in clean contaminated surgery. Br J Surg 2010, 97(11):1614-1620.
55. Siegrist T.C., Kwon E.O., Fracchia J.A., et al. The "no-touch" technique: a novel technique for reducing post-operative infections in patients receiving multi-component inflatable penile prostheses. J Urol 2008, 179(Suppl 4):404.
56. Kjonniksen I., Andersen B.M., Sondenaa V.G., et al. Preoperative hair removal-a systematic literature review. AORN J 2002, 75:928-938. 940.
57. Kirby J.P., Mazuski J.E. Prevention of surgical site infection. Surg Clin North Am 2009, 89:365-389.
58. Domes T, Grober E. Pre-operative hair removal on the male genitala-clippers versus razors: support for the SMSNA position [abstract 104]. In: Program book for the 16th annual fall scientific meeting of the Sexual Medicine Society of North America, Inc. Miami (Fl), November 11-14, 2010. p. 247.
59. Rao N., Cannella B., Crossett L.S., et al. A preoperative decolonization protocol for staphylococcus aureus prevents orthopedic infections. Clin Orthop Relat Res 2008, 466(6):1343-1348.
60. Walsh E.E., Greene L., Kirshner R. Sustained reduction in methicillin-resistant Staphylococcus aureus wound infections after cardiothoracic surgery. Arch Intern Med 2011, 171(1):68-73.
61. Wolf J.S., Bennett C.J., Dmochowski R.R., et al. Best practice policy statement on urologic surgery antimicrobial prophylaxis. J Urol 2008, 179:1379-1390.
62. Wosnitzer M., Greenfield J. Antibiotic patterns among urologists who perform inflatable penile prosthesis insertion. J Sex Med 2010, 7(Suppl 1):12.
63. Henry G.D., Wilson S.K., Delk J.R., et al. Revision washout decreases penile prosthesis infection in revision surgery: a multicenter study. J Urol 2005, 173:89-92.
64. Henry G.D., Carson C.C., Wilson S.K., et al. Revision washout decreases implant capsule tissue culture positivity: a multicenter study. J Urol 2008, 179:186-190.
65. Carson C.C. Efficacy of antibiotic impregnation of inflatable penile prostheses in decreasing infection in original implants. J Urol 2004, 171(4):1611-1614.
66. Carson C.C., Mulcahy J.J., Harsch M.R. Long-term infection outcomes after original antibiotic impregnated inflatable penile prosthesis implants: up to 7.7 years of followup. J Urol 2011, 185(2):614-618.
67. Wolter C.E., Hellstrom W.J. The hydrophilic-coated inflatable penile prosthesis: 1-year experience. J Sex Med 2004, 1(2):221-224.
68. Richardson B., Caire A., Hellstrom W. Retrospective long-term analysis of Titan hydrophilic coating: positive reduction of infection compared to non-coated device. J Sex Med 2010, 7(Suppl 1):28.
69. Dhabuwala C., Sheth S., Zamzow B. Infection rate of rifampin/gentamicin-coated titan coloplast penile implants. Comparison with Inhibizone-impregnated AMS penile implants. J Sex Med 2011, 8(1):315-320.
70. Wilson SK. The ideal antibiotic dip for the Coloplast Titan prosthesis [abstract: 99]. In: Program book of the 16th annual fall scientific meeting of the Sexual Medicine Society of North America, Inc. Miami (Fl), November 11-14, 2010. p. 242.
71. Abouassaly R., Angermeier K.W., Montague D.K. Risk of infection with an antibiotic coated inflatable penile prosthesis at device replacement for mechanical failure. J Urol 2006, 176:2471-2473.
72. Sadeghi-Najed H., Ilbeigi P., Wilson S.K., et al. Multi-institutional outcome study on the efficacy of closed-suction drainage of the scrotum in three-piece inflatable penile prosthesis surgery. Int J Impot Res 2005, 17:535-538.
73. Garber B.B. Mentor Alpha 1 inflatable penile prosthesis: patient satisfaction and device reliability. Urology 1994, 43(2):214-217.
74. Montague D.K., Angermeier K.W., Lakin M.M. Penile prosthesis infection. Int J Impot Res 2001, 13:326-328.
75. McClellan D.S., Masih B.K. Gangrene of the penis as a complication of penile prosthesis. J Urol 1985, 133(5):862-863.
76. Fishman I.J., Scott F.B., Selam I.N. Rescue procedure: an alternative to complete removal for treatment of infected penile prosthesis. J Urol 1987, 137:202A.
77. Parsons C.L., Stein P.C., Dobke M.K., et al. Diagnosis and therapy of subclinically infected prostheses. Surg Gynecol Obstet 1993, 177:504-506.
78. Mulcahy J.J. Penile prosthesis infection: progress in prevention and treatment. Curr Urol Rep 2010, 11:400-404.
79. Maatman T.J., Montague D.K. Intracorporeal drainage after removal of infected penile prostheses. Urology 1984, 23(2):184-185.
80. Kim J.C., Lunati F.P., Khan S.A., et al. T-tube drainage of infected penile corporeal chambers. Urology 1995, 45(3):514-515.
81. Mulcahy J.J. Treatment alternatives for the infected penile implant. Int J Impot Res 2003, 15(Suppl 5):S147-S149.
82. Furlow W.F., Goldwasser B. Salvage of the eroded inflatable penile prosthesis: a new concept. J Urol 1987, 138:312-316.
83. Carson C.C. Diagnosis, treatment, and prevention of penile prosthesis infection. Int J Impot Res 2003, 15(Suppl 5):S139-S146.
84. Lue T.F. Penile prosthetic infections: management by delayed and immediate salvage techniques. J Urol 1999, 161(5):1727-1728.