Infection following penile prosthesis placement at an academic training center remains low despite involvement of surgeons-in-training

Abstract

PurposePrimary care providers harbor misconceptions regarding penile prosthetic surgery, largely overestimating the rate of infection. Rates of infection following surgery for primary placement and revision are estimated as 1% to 3% and 10% to 18%, respectively. Our objective was to determine the contemporary incidence of infection following inflatable penile prostheses surgery at an academic training center where surgeons-in-training are routinely involved.Materials and MethodsReview of a prospectively collected single-surgeon database was performed. All cases of inflatable penile prostheses placement from January 2011 through June 2017 were reviewed. Information regarding training level of assistant surgeon(s) was collected, and follow-up data was compiled regarding postoperative infections and need for revision surgery.ResultsThree hundred nine cases meeting inclusion criteria were identified. Mean patient age was 64.2 years, and mean follow-up was 28.7 months. Distribution involved 257 (83.2%) for primary placement, 45 (14.6%) for removal/replacement, and 7 (2.3%) in setting of prior device removal. Diabetes was noted in 31.1% of men. Surgeon-in-training involvement was noted in 100% of cases. Infection was confirmed in a patient who had skin breakdown over an area of corporal reconstruction with polytetrafluoroethylene. The overall postoperative infection rate was 0.3%.ConclusionsIn this series from an academic training center, infection following penile prosthetic surgery is low, similar to other centers of excellence, even with 100% involvement of surgeons-in-training. This data should be used to better inform primary care providers and members of the general public potentially interested in restoration of sexual function.

Ten-year experience with penile prosthetic surgery for the treatment of erectile dysfunction

“…Similar to previous reports, we did not find any correlation between patient age, history of urinary diversion, history of pelvic radiotherapy, obesity, and EPI. 12 24 25 26 27 28 29 30 31 32 33 Furthermore, we failed to find any association between EPI and active smoking status. Despite this, the negative effect of tobacco smoking in the immediate postoperative setting has been well documented.…”

“…This finding is similar to that reported by McAbee et al . 28 from an academic training center, where the rate of infections following PP placement remained low despite involvement of surgeons-in-training.…”

Penile Prosthesis Infection: Myths and Realities

“…Historically, academic institutions have implanted significant numbers of penile prostheses. The experience of surgeons-in-training and their participation in IPP implantation did not increase the rate of postoperative IPP infection in a recent retrospective review, of a high-volume implanter in an academic setting [72]. A review of the New York Statewide Planning and Research Cooperative System database revealed 14,969 men who underwent IPP placement between 1995 and 2014.…”

Impact of residents’ involvement in urological surgeries: a systematic review

“…A previous study by Nieder et al reported that the rate of complications after transurethral bladder tumor resection, the rate of complications was 5.8% for both fellow and resident trainees under supervision. 37 However, the authors reported that the rates of complications and bladder perforation could be more frequent with senior urologists than trainees, however, no statistical analysis was done. Moreover, McAbee et al reported that the rate of infection was 0.3% only following penile prosthesis placement surgeries.…”