Penile Prosthesis Infection: Progress in Prevention and Treatment

Abstract

Almost four decades ago, modern penile implants were introduced as a treatment of erectile dysfunction. Infection associated with placement of an implant is a feared complication, and fortunately, has become less common due to a number of measures, including antibiotic-coated devices and chlorhexidine-alcohol skin preparation. When an infection around an implant occurs, the device should be removed. An option, termed a salvage (or rescue) procedure, is cleansing the wound with a series of antiseptic solutions and replacing a new prosthesis during the same procedure, with success in the range of 85%. The alternative is to return at a later date to replace the implant. However, the latter approach is associated with a difficult insertion, a shorter erection, and a less satisfied patient. Most patients elected the salvage approach because they were highly motivated to continue sexual activity to have the implant placed initially.

Infection Retardant Coated Inflatable Penile Prostheses Decrease the Incidence of Infection: A Systematic Review and Meta-Analysis

“…6 In 1936 innovations by the Russian surgeon Borgoraz using rib cartilage to support the penis 6 led to the development in 1949 of the first acrylic subcutaneous penile prosthesis. 7 Further advancement evolved to 3-piece inflatable implants in 1973, which are currently used today. 4 Prosthetic infection remains an important, devastating complication associated with this surgery and manufacturers have introduced new strategies to decrease this risk.…”

The Status of Biofilms in Penile Implants

“…Treatment usually progresses from oral medications, to directly injectable medications, and the final, permanent option of an implantable penile prosthetic. Penile implants have evolved from the original subcutaneous acrylic implant in 1949 [9], the first three-piece inflatable penile prosthesis (IPP) in 1973 [10], to the modern IPPs used today.…”

Complications and Problems of Penile Prosthetic Surgery in a Series of 530 Cases Operated on by the Same Surgeon in Italy

“…Infections are one of the leading causes of implant failure. For practical and above all economic reasons (given the high cost of IPP, the replacement of which might not be covered by health insurance), various "salvage" procedures have been proposed for reusing the same IPP after antibiotic "disinfection" (20).…”