Overview
Penile prosthesis infection is a serious complication following penile implant surgery, potentially leading to device explantation and significant morbidity. Prevention strategies vary among surgeons, highlighting the need for standardized protocols 1.Diagnosis
Clinical signs include persistent pain, swelling, and purulent discharge post-surgery 1.
Routine urine cultures are inconsistently performed, with significant variability among practitioners (40-50% do not routinely perform them) 1.
Imaging (e.g., ultrasound) may be used to assess for signs of infection or device complications 1.Management
Debridement and antibiotic therapy: Initial management often involves surgical debridement and targeted antibiotic therapy based on culture and sensitivity results 1.
Device explantation: In cases of confirmed infection, removal of the prosthesis is typically required 1.
Reimplantation: Delayed reimplantation after infection resolution, often months later, is common practice 1.Special Populations
Variability in practices: There is noted variability in preoperative shaving techniques (razors vs. clippers) between different societies (ISSM vs. SMSNA), but specific recommendations for special populations like the elderly or those with comorbidities are not detailed 1.Key Recommendations
Routine preoperative urine cultures should be considered to identify asymptomatic bacteriuria that could predispose to infection (Evidence: Moderate 1).
Standardized preoperative skin preparation protocols, including consistent use of antimicrobial scrubs, are recommended to reduce infection risk (Evidence: Expert opinion 1).
Surgeons should weigh the benefits of preoperative shaving techniques carefully, with some preference shown for non-razor methods to minimize skin trauma (Evidence: Expert opinion 1).References
1 Katz DJ, Stember DS, Nelson CJ, Mulhall JP. Perioperative prevention of penile prosthesis infection: practice patterns among surgeons of SMSNA and ISSM. The journal of sexual medicine 2012. link