Joseph Mahon1, Ryan Dornbier1, Grace Wegrzyn2, Martha M Faraday3, Hossein Sadeghi-Nejad4, Lawrence Hakim5, Kevin T McVary6. 1. Center for Male Health, Department of Urology, Loyola University Stritch School of Medicine, Maywood, IL. 2. Loyola University Stritch School of Medicine, Maywood, IL. 3. Four Oaks Consulting, Inc, Berryville, VA. 4. Department of Urology, Hackensack University Medical Center, Hackensack, NJ, and Division of Urology, Rutgers New Jersey Medical School, Newark, NJ. 5. Department of Urology, Cleveland Clinic Florida, Weston, FL. 6. Center for Male Health, Department of Urology, Loyola University Stritch School of Medicine, Maywood, IL. Electronic address: kmcvary@gmail.com.
Abstract
INTRODUCTION: Infection remains a prominent concern following penile implantation. Recognition of the risk factors for infection may help to guide surgeons toward reducing the risk of prosthetic contamination. AIM: To gain a further understanding of infectious adverse events following penile prosthesis, we performed a systematic literature review. METHODS: As part of the 2018 American Urological Association Erectile Dysfunction Clinical Guidelines and with the support of the American Urological Association, we performed a comprehensive review of the PubMed, Embase, and Cochrane databases to search for eligible articles published between January 1, 1965, and July 20, 2016, to identify articles reporting infectious adverse events following prosthesis placement. MAIN OUTCOME MEASURE: The main outcome measure was infectious adverse events following penile prosthesis placement. RESULTS: Ninety-one articles reporting infectious adverse events representing 97 study arms were identified. Prosthetic infection rates ranged from 0% to 24.6% across all series. Inflatable penile prostheses displayed a wider range (0-24.6%) than malleable devices (0-9.1%); the most frequently reported infection rate for inflatable devices was 5% or less. With the advent of device coatings and improved surgical techniques, infectious adverse events have decreased. Infections among diabetic patients also decreased throughout the reviewed body of literature, with the most recent series reporting rates consistent with those of non-diabetic patients. Furthermore, no glycosylated hemoglobin cutoff was found to infer increased or decreased risk of prosthesis infection. CONCLUSION: Overall penile prosthetic infectious adverse events have decreased as surgical techniques have improved and the use of antimicrobial coating has gained in popularity. These advances have demonstrated significant benefits for all patients, particularly diabetic patients who experience infection rates similar to those of non-diabetic patients in recent reports. Further technological advancements for the prevention of biofilm formation is warranted. Mahon J, Dornbier R, Wegrzyn G, et al. Infectious Adverse Events Following the Placement of a Penile Prosthesis: A Systematic Review. Sex Med Rev 2020;8:348-354.
INTRODUCTION: Infection remains a prominent concern following penile implantation. Recognition of the risk factors for infection may help to guide surgeons toward reducing the risk of prosthetic contamination. AIM: To gain a further understanding of infectious adverse events following penile prosthesis, we performed a systematic literature review. METHODS: As part of the 2018 American Urological Association Erectile Dysfunction Clinical Guidelines and with the support of the American Urological Association, we performed a comprehensive review of the PubMed, Embase, and Cochrane databases to search for eligible articles published between January 1, 1965, and July 20, 2016, to identify articles reporting infectious adverse events following prosthesis placement. MAIN OUTCOME MEASURE: The main outcome measure was infectious adverse events following penile prosthesis placement. RESULTS: Ninety-one articles reporting infectious adverse events representing 97 study arms were identified. Prosthetic infection rates ranged from 0% to 24.6% across all series. Inflatable penile prostheses displayed a wider range (0-24.6%) than malleable devices (0-9.1%); the most frequently reported infection rate for inflatable devices was 5% or less. With the advent of device coatings and improved surgical techniques, infectious adverse events have decreased. Infections among diabeticpatients also decreased throughout the reviewed body of literature, with the most recent series reporting rates consistent with those of non-diabeticpatients. Furthermore, no glycosylated hemoglobin cutoff was found to infer increased or decreased risk of prosthesis infection. CONCLUSION: Overall penile prosthetic infectious adverse events have decreased as surgical techniques have improved and the use of antimicrobial coating has gained in popularity. These advances have demonstrated significant benefits for all patients, particularly diabeticpatients who experience infection rates similar to those of non-diabeticpatients in recent reports. Further technological advancements for the prevention of biofilm formation is warranted. Mahon J, Dornbier R, Wegrzyn G, et al. Infectious Adverse Events Following the Placement of a Penile Prosthesis: A Systematic Review. Sex Med Rev 2020;8:348-354.
Authors: Valentine Frydman; Ugo Pinar; Maher Abdessater; William Akakpo; Pietro Grande; Marie Audouin; Pierre Mozer; Emmanuel Chartier-Kastler; Thomas Seisen; Morgan Roupret Journal: Basic Clin Androl Date: 2021-03-04