Infected penile prosthesis: literature review highlighting the status quo of prevention and management
Affiliations
Affiliations
- Urology Unit, Department of Surgery, Amiri Hospital, Kuwait City, Kuwait.
- Kuwait Urology Board, Kuwait Institute for Medical Specialization, Kuwait City, Kuwait.
- Urology Unit, Department of Surgery, Farwaniya Hospital, Kuwait City, Kuwait
Abstract
Introduction: Erectile dysfunction affects over 50% of men 70 years and above, and penile prosthesis (PP) is its third-line treatment. Complications of PPs include infection, however, no formal guidelines exist for its management.
Methods: We performed a literature search and reviewed 53 recent published literatures of experiences with management of PP infections, prevention, and treatment.
Results: Acute infection can present early with pain and discharge and detection of early signs is of utmost importance. MRI studies are more sensitive than CT studies to diagnose and plan surgical intervention. Introduction of antibiotic impregnated devices attributed to the reduction of infection rates with superiority proven for certain types; the no-touch technique had further reduced this rate. The Mulcahy salvage remains the most widely used surgical approach for treatment despite modifications and novel techniques described; conservative management of PP infections is recently reported with promising results.
Conclusions: Despite absence of strict guidelines for the management of infected PPs, we reviewed and discussed numerous panel opinions and suggestions throughout literature. More research into the pathology, prevention, conservative management and advances in surgical treatment of this condition are called for to produce guidelines that unite the efforts to tackle these infections.
Keywords: Penile prosthesis; erectile dysfunction; infections; prosthesis.
Similar articles
Gross MS, Phillips EA, Carrasquillo RJ, Thornton A, Greenfield JM, Levine LA, Alukal JP, Conners WP 3rd, Glina S, Tanrikut C, Honig SC, Becher EF, Bennett NE, Wang R, Perito PE, Stahl PJ, Rosselló Gayá M, Rosselló Barbará M, Cedeno JD, Gheiler EL, Kalejaiye O, Ralph DJ, Köhler TS, Stember DS, Carrion RE, Maria PP, Brant WO, Bickell MW, Garber BB, Pineda M, Burnett AL 2nd, Eid JF, Henry GD, Munarriz RM.J Sex Med. 2017 Mar;14(3):455-463. doi: 10.1016/j.jsxm.2017.01.007. Epub 2017 Feb 8.PMID: 28189561
Diagnosis, treatment and prevention of penile prosthesis infection.
Carson CC.Int J Impot Res. 2003 Oct;15 Suppl 5:S139-46. doi: 10.1038/sj.ijir.3901091.PMID: 14551594 Review.
Penile Implant: Review of a "No-Touch" Technique.
Eid JF.Sex Med Rev. 2016 Jul;4(3):294-300. doi: 10.1016/j.sxmr.2016.01.002. Epub 2016 Apr 5.PMID: 27871962 Review.
Kashanian JA, Golan R, Sun T, Patel NA, Lipsky MJ, Stahl PJ, Sedrakyan A.J Sex Med. 2018 Feb;15(2):245-250. doi: 10.1016/j.jsxm.2017.12.005. Epub 2017 Dec 29.PMID: 29292061
Gross MS, Phillips EA, Balen A, Eid JF, Yang C, Simon R, Martinez D, Carrion R, Perito P, Levine L, Greenfield J, Munarriz R.J Urol. 2016 Mar;195(3):694-7. doi: 10.1016/j.juro.2015.08.091. Epub 2015 Sep 3.PMID: 26343986
References
https://pubmed.ncbi.nlm.nih.gov/