Mohamad Habous1, Mohammed Farag2, Ben Williamson3, Osama Laban4, Saad Mahmoud5, Osama Abdelwahab6, Mohamed Elkhouly5, Usama Kamil5, Saleh Binsaleh7, Raanan Tal8, David Ralph9, John P Mulhall10. 1. Elaj Medical Centers, Urology and Andrology Department, Jedda, Saudi Arabia. Electronic address: drmhabos@hotmail.com. 2. Al-azhar University, Urology Department, Cairo, Egypt. 3. University Hospitals Birmingham, Birmingham, UK. 4. King Khaled Hospital, Tabouk, Saudi Arabia. 5. Elaj Medical Centers, Urology and Andrology Department, Jedda, Saudi Arabia. 6. Benha University, Urology Department, Benha, Egypt. 7. Division of Urology, Department of Surgery, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia. 8. Male Sexual Dysfunction & Male Infertility, Urology Department, Rambam Health Care Campus, Haifa, Israel. 9. St Peters Andrology Centre &The Institute of Urology, UCLH, London, UK. 10. Sexual & Reproductive Medicine Program, Memorial Sloan Kettering Cancer Center, New York, USA.
Abstract
INTRODUCTION: Traditionally, penile implant (PI) infections have been managed by removal with immediate or delayed replacement. Recently, interest has been focused on conservative therapy (CT) using antibiotic therapy. AIM: To investigate the success rate and predictive factors affecting the outcome of CT in PI infection patients. METHODS: Patients diagnosed with early, localized PI infection were considered candidates for CT. Exclusion criteria included temperature >37.5°C, WBC >13,000/μL, and appearance of any sign of sepsis. In patients with purulent drainage, culture swabs were taken and an antibiotic was chosen based on sensitivity results. Oral antibiotics were used until the local infection was completely resolved. Patients were evaluated weekly during this process. RESULTS: Thirty-seven patients were retrospectively reviewed and constituted the study population. Mean age was 58.1 (range 37-85; SD 9.9) years. All were diabetic. Mean BMI was 31.8 (range 24-47; SD 5.0). PI was malleable in 33 cases and inflatable in 4 cases. Culture results (n = 19) included Staphylococcus epidermidis (42 %), pseudomonas (21%), Escherichia coli (21%), and S aureus (16%). Four of 37 patients needed the PI removed due to CT failure and onset of systemic symptoms, at a mean time-point of 75 ± 1.8 days after CT commencement. In men who were cured, mean time to complete healing was 49 (range 29-97; SD 15.8) days. Two of 37 patients (5%) had PI removal because of persistent penile pain despite complete wound healing, at a mean time point of 128 ± 2.5 days after CT commencement. All men managed conservatively resumed sexual intercourse. CONCLUSION: CT of localized PI infection appears to be a viable option for such patients, with the majority of patients retaining their implant and resuming sexual activity.
INTRODUCTION: Traditionally, penile implant (PI) infections have been managed by removal with immediate or delayed replacement. Recently, interest has been focused on conservative therapy (CT) using antibiotic therapy. AIM: To investigate the success rate and predictive factors affecting the outcome of CT in PI infectionpatients. METHODS:Patients diagnosed with early, localizedPI infection were considered candidates for CT. Exclusion criteria included temperature >37.5°C, WBC >13,000/μL, and appearance of any sign of sepsis. In patients with purulent drainage, culture swabs were taken and an antibiotic was chosen based on sensitivity results. Oral antibiotics were used until the local infection was completely resolved. Patients were evaluated weekly during this process. RESULTS: Thirty-seven patients were retrospectively reviewed and constituted the study population. Mean age was 58.1 (range 37-85; SD 9.9) years. All were diabetic. Mean BMI was 31.8 (range 24-47; SD 5.0). PI was malleable in 33 cases and inflatable in 4 cases. Culture results (n = 19) included Staphylococcus epidermidis (42 %), pseudomonas (21%), Escherichia coli (21%), and S aureus (16%). Four of 37 patients needed the PI removed due to CT failure and onset of systemic symptoms, at a mean time-point of 75 ± 1.8 days after CT commencement. In men who were cured, mean time to complete healing was 49 (range 29-97; SD 15.8) days. Two of 37 patients (5%) had PI removal because of persistent penile pain despite complete wound healing, at a mean time point of 128 ± 2.5 days after CT commencement. All men managed conservatively resumed sexual intercourse. CONCLUSION: CT of localizedPI infection appears to be a viable option for such patients, with the majority of patients retaining their implant and resuming sexual activity.
Authors: Khalid Seghrouchni; Christian van Delden; Dennis Dominguez; Mohamed Benkabouche; Louis Bernard; Mathieu Assal; Pierre Hoffmeyer; Ilker Uçkay Journal: Int Orthop Date: 2011-10-05 Impact factor: 3.075