Penile implant infection factors: a contemporary narrative review of literature

Baird, Bryce; Parikh, Kevin; Broderick, Gregory A.

doi:10.21037/tau-21-568

Cited by 9 publications

(4 citation statements)

References 78 publications

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“…Surgical factors can include antibiotics used in any stage of the surgery, pre-surgical scrubbing, surgeon experience (although showing relatively weaker evidence), surgical technique, and hair removal. Antimicrobial selection for the pre-operative stage can include aminoglycoside combined with a first- or second-generation cephalosporin or vancomycin [ 16 ]. In addition, most surgeons apply some sort of antibiotics peri-operatively [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Successful Conservative Therapy for Infected Penile Implants: A Case Series

Alkeraithe,

AlFakhri,

Alghafees

et al. 2023

Am J Case Rep

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Case series Patients: Male, 41-year-old • Male, 62-year-old • Male, 61-year-old • Male, 61-year-old Final Diagnosis: Infection Symptoms: Penile and scrotal pain Clinical Procedure: — Specialty: Urology Objective: Unusual clinical course Background: Traditionally, penile implant infections have been treated by removal followed by immediate or delayed replacement. The use of antibiotics in conservative therapy has recently attracted attention. Case Reports: We report our experience with 4 cases of infected penile implants managed conservatively. Case 1 was a 41-year-old with sickle cell anemia who presented with low-grade fever and purulent discharge that started 1 month postoperatively and lasted for 3 weeks. He had left graft after fibrotic tissue excision with 14-mm collection in the left corpus cavernosum. He was managed with IV pipracillin/tazobactam and vancomycin for 13 days. Follow-up after 23 weeks showed complete wound healing. Case 2 was a 62-year-old with diabetes who had purulent discharge that started 41 days postoperatively and lasted for 1 week. He received 5 days of IV vancomycin and gentamycin. Follow-up after 4 weeks showed marked improvement of the wound. Case 3 was a 61-year-old with diabetes and ischemic heart disease. He presented 30 days postoperatively with fever, puru-lent discharge for 5 days. He received a total of 10 days of IV vancomycin and gentamycin. Follow-up 3 weeks after discharge showed complete wound healing. Case 4 was a 61-year-old with diabetes and ischemic heart disease. He presented 1 month postoperatively with fever and pus discharge for 1 week. He completed 10 days of IV vancomycin and gentamycin. Follow-up after 1 week showed marked wound healing. Conclusions: Choosing patients with early superficial infected penile prosthesis for conservative management should be tailored to selected patients who does not have leukocytosis, signs of sepsis, high-grade fever, or an exposed device.

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Section: Discussionmentioning

confidence: 99%

Successful Conservative Therapy for Infected Penile Implants: A Case Series

Alkeraithe,

AlFakhri,

Alghafees

et al. 2023

Am J Case Rep

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“…Penile prostheses (PPs), including inflatable PPs (IPPs) and semi-rigid prostheses, are the mainstay treatment for refractory ED, although only 5% of eligible patients receive them ( 3 , 4 ). The most feared complication following PP placement is device infection, which is associated with severe morbidity, pain, penile length loss, and financial costs ( 5 , 6 ). Infection often requires reoperation for PP removal, after which reimplantation may be difficult due to fibrosis ( 7 ).…”

Section: Introductionmentioning

confidence: 99%

Addressing the need for preclinical study of penile prosthesis infection: a new animal model and narrative review

Shah,

Liu,

Machado

et al. 2024

Transl Androl Urol

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Background and Objective Erectile dysfunction (ED) is a common condition in men, and many patients refractory to conservative treatment may undergo penile prostheses (PPs) placement. The primary concern following PP implantation is device infection. Although antibiotic and hydrophilic coatings have reduced the incidence of inflatable PP (IPP) infections, there remains room for improvement. Optimization of PP outcomes requires a practical in vivo model to better understand mechanisms of infection and to test new infection control strategies. We aimed to describe a new rabbit model which contains a functional IPP and review previously reported animal PP models. Methods An IPP was placed into rabbit flanks and cycled for functionality testing. Rabbits were evaluated for signs of pain and distress over 14 days. Separately, narrative review methodology was utilized to search the PubMed and Scopus databases for all publications through March 21, 2023, which studied PP within an in vivo setting. Three independent reviewers ultimately selected 12 papers from 1992–2021 for inclusion. Key Content and Findings Several animal studies highlighted the initial functionality or feasibility of devices for ED before their introduction in the clinical setting. There are several subsequent studies aimed at optimizing the type of antibiotic use or coating material using segments of PP material in an in vivo setting. However, the literature lacks a contemporary animal model containing a functional IPP. Our novel rabbit model offers a safe, practical way to implant a functioning IPP and investigate new perioperative infection prevention and treatment strategies before trials in the clinical setting. Conclusions Animal models have played a key role in testing medical devices, including PPs, prior to their clinical introduction. Our review uncovered no modern animal studies involving placement of a functional PP. A new animal model can facilitate study of evolving microorganism profiles, novel methods to enhance antibiotic delivery, and proposed treatment options.

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“…At present, the main forms of penile reconstruction include pedicled skin flaps and free microsurgical flaps, both of which have limited ability to reproduce the complex structure of the penis and are often associated with significant donor site complications (4)(5)(6). Although traditional plastic surgery can produce satisfactory outcomes in many cases, it is still laden with significant donor site morbidity, prosthesis extrusion, and catastrophic infections (7,8). In addition, increasingly, more patients with traumatic penis loss and concomitant limb injury, especially wartime injuries, are not suitable for autologous reconstruction due to a lack of sufficient donor sites (9).…”

Section: Introductionmentioning

confidence: 99%

Constructing a heparin-modified penile decellularized scaffold to improve re-endothelialization in organizational reconstruction

Zhang¹,

Song²,

Ni³

et al. 2022

Transl Androl Urol

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Background: Due to the unique anatomy and complex function of the penis, the reconstruction of penile defect is fraught with great challenges. The current standard methods are limited by numerous complications and insufficient donor sites. While functional vascularized penile tissue engineering offers a novel way to address this problem, revascularization remains the primary concern.Methods: In this study, a penile scaffold with associated modifications was constructed. The performance of decellularized penile scaffolds (DPSs) was improved by conjugation with heparin (HEP) and reseeding with human umbilical vein endothelial cells (HUVECs). There were three groups according to the modifications, including native DPSs, HEP-DPSs, HEP-HUVECs-DPSs. After perfusing with 1% Triton X-100/0.1% ammonium hydroxide solution, the cellular components were removed. Subsequently, the covalent binding of heparin in the DPSs was performed with 1-ethyl-3-(3-dimethylaminopropyl)-carbodiimide/ N-hydroxysuccinimide, followed by reseeding with HUVECs. Scaffolds were implanted into the backs of rats and the implanted tissues were harvested at 1, 2, 3, and 4 weeks. Then hematoxylin and eosin (H&E) staining and immunofluorescence assays were performed to assess the degree of angiogenesis. Results:The native DPSs retained the extracellular matrix and heparinized modification. The H&E results indicated that more HUVECs covered the inner surface of tubular structures in the HEP-DPSs group compared to the native DPSs group. The number of vessels in the HEP-HUVECs-DPSs was significantly increased compared to the control scaffolds at all time points.Conclusions: These results suggested that, compared to the native DPS, heparin-conjugated scaffolds provided a superior environment for the growth of HUVECs and the modified methods provided a perspective for overcoming the obstacles in tissue engineering of transplantable penile tissues and the establishment of a functional vasculature.

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Penile implant infection factors: a contemporary narrative review of literature

Cited by 9 publications

References 78 publications

Successful Conservative Therapy for Infected Penile Implants: A Case Series

Successful Conservative Therapy for Infected Penile Implants: A Case Series

Addressing the need for preclinical study of penile prosthesis infection: a new animal model and narrative review

Constructing a heparin-modified penile decellularized scaffold to improve re-endothelialization in organizational reconstruction

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