Evaluating the Role of Postoperative Oral Antibiotic Administration in Artificial Urinary Sphincter and Inflatable Penile Prosthesis Explantation: A Nationwide Analysis

Adamsky, Melanie; Boysen, William R.; Cohen, Andrew J.; Ham, Sandra A.; Dmochowski, Roger R.; Faris, Sarah; Bales, Gregory T.; Cohn, Joshua A.

doi:10.1016/j.urology.2017.07.064

Cited by 16 publications

(10 citation statements)

References 25 publications

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“…Perioperative antibiotic prophylaxis has been demonstrated to be effective in reducing infections rates, based on studies on orthopedic prosthetic surgery . However, recently, Adamsky et al evidenced in a large cohort of 3594 AUS implants that nearly one third of patients (61.1%) are prescribed postoperative antibiotic therapy and that it does not reduce the odds of AUS explant …”

Section: Discussionmentioning

confidence: 99%

“…39 However, recently, Adamsky et al evidenced in a large cohort of 3594 AUS implants that nearly one third of patients (61.1%) are prescribed postoperative antibiotic therapy and that it does not reduce the odds of AUS explant. 40 Diabetes mellitus is a reported risk factor for prosthesis infection. 41 Anticoagulant therapy is a known risk factor for bleeding complications, which in turn, can lead to infection and erosion.…”

Section: Discussionmentioning

confidence: 99%

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Efficacy and safety of artificial urinary sphincter (AUS): Results of a large multi‐institutional cohort of patients with mid‐term follow‐up

Tutolo

Cornu

Bauer

et al. 2018

Neurourology and Urodynamics

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Aims To assess efficacy and safety as well as predictive factors of dry rate and freedom from surgical revision in patients underwent AUS placement. The artificial urinary sphincter (AUS) is still considered the standard for the treatment of moderate to severe post‐prostatectomy stress urinary incontinence (SUI). However, data reporting efficacy and safety from large series are lacking. Methods A multicenter, retrospective study was conducted in 16 centers in Europe and USA. Only primary cases of AUS implantation in non‐neurogenic SUI after prostate surgery, with a follow‐up of at least 1 year were included. Efficacy data (continence rate, based on pad usage) and safety data (revision rate in case of infection and erosion, as well as atrophy or mechanical failure) were collected. Multivariable analyses were performed in order to investigate possible predictors of the aforementioned outcomes. Results Eight hundred ninety‐two men had primary AUS implantation. At 32 months mean follow‐up overall dry rate and surgical revision were 58% and 30.7%, respectively. Logistic regression analysis showed that patients without previous incontinence surgery had a higher probability to be dry after AUS implantation (OR: 0.51, P = 0.03). Moreover institutional case‐load was positively associated with dry rate (OR: 1.18; P = 0.005) and freedom from revision (OR: 1.51; P = 0.00). Conclusions The results of this study showed that AUS is an effective option for the treatment of SUI after prostate surgery. Moreover previous incontinence surgery and low institutional case‐load are negatively associated to efficacy and safety outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of artificial urinary sphincter (AUS): Results of a large multi‐institutional cohort of patients with mid‐term follow‐up

Tutolo

Cornu

Bauer

et al. 2018

Neurourology and Urodynamics

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“…Regarding perioperative antibiotic regimen, our team follows current AUA guidelines for implanted prostheses, in which an aminoglycoside plus vancomycin is administered for 24 hours. Our patients are also discharged with antibiotics for one week post-operatively, though the efficacy of this practice remains controversial (33,34).…”

Section: Post-operative Complicationsmentioning

confidence: 99%

Techniques and considerations of prosthetic surgery after phalloplasty in the transgender male

Kang¹,

Aizen²,

Cohen

et al. 2019

Transl. Androl. Urol

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For many transgender males, "lower" or "bottom" surgery (the construction of a phallus and scrotum) is the definitive step in their surgical journey for gender affirmation. The implantation of penile and testicular prostheses is often the final anatomic addition and serves to add both functionality and aesthetics to the reconstruction. However, with markedly distinctive anatomy from cis-gender men, the implantation of prostheses designed for cis-male genitalia poses a significant surgical challenge for the reconstructive urologist. The surgical techniques for these procedures remain in their infancy. Implantation of devices originally engineered for cis-men is an imperfect solution but not insurmountable if approached with ingenuity, patience, and persistence. Urologists and patients undergoing implantation should be aware of the high complication rates associated with these procedures as well as the current uncertainty of long-term outcomes. This review provides a comprehensive overview of the perioperative considerations, adaptive surgical techniques, and unique complications of penile and testicular prosthetic implantation in transgender men.

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“…The other study was a retrospective review by Dropkin et al [ 43 44 ]. It included 222 patients who presented for IPP insertion and were divided into three groups.…”

Section: Postoperative Measuresmentioning

confidence: 99%

Tips and tricks in the management of inflatable penile prosthesis infection: A review

Brimley

Yousif

Kim

2021

Arab Journal of Urology

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Objective:: To review the management of inflatable penile prosthesis (IPP) infection. Methods: The 'gold-standard' treatment for medication-refractory erectile dysfunction is the IPP, wherein the most dreaded complication is infection. To prevent and manage an infected IPP requires a strict protocol during the pre-, intra-, and postoperative course. A variety of techniques and antibiotics are used in conjunction with IPP implantation to prevent contamination. This modified Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) review of the literature examines the current practices by leading urologists in the management of IPP infection, as well as provides insights for improved patient outcomes. Results: : Patient selection is important to reduce IPP infections, and those with risk factors need to be optimised prior to surgery. Proper antibiotic prophylaxis includes pre-, intra-, and postoperative administration. As most infections derive from normal skin flora, every measure must be taken to sterilise the skin and avoid direct device skin contact. Up to 3% of virgin IPPs develop infections and this number increases to 18% in revision cases. Antibiotic coverage depends on the presenting microbe, which can vary significantly between patients. Conclusions: : A greater success in IPP implantation can be attributed to appropriate prophylaxis, field sterilisation, and surgical technique. For those implants that do become infected, often erectile function can be preserved by immediate antibiotic coverage combined with salvage procedures.

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Evaluating the Role of Postoperative Oral Antibiotic Administration in Artificial Urinary Sphincter and Inflatable Penile Prosthesis Explantation: A Nationwide Analysis

Cited by 16 publications

References 25 publications

Efficacy and safety of artificial urinary sphincter (AUS): Results of a large multi‐institutional cohort of patients with mid‐term follow‐up

Efficacy and safety of artificial urinary sphincter (AUS): Results of a large multi‐institutional cohort of patients with mid‐term follow‐up

Techniques and considerations of prosthetic surgery after phalloplasty in the transgender male

Tips and tricks in the management of inflatable penile prosthesis infection: A review

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