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Prevention of Prosthetic Infection: Penile Implants and Artificial Urinary Sphincters

  • Lael Reinstatler
  • Ricardo M. Munarriz
  • Martin S. Gross
Chapter

Abstract

Introduction: Infections in urologic prosthetic surgery are complex complications for patients and surgeons.

Methods: A literature review was conducted to identify all studies related to infections in penile prosthetic and artificial urinary sphincter surgery.

Results: Significant improvements have been made in urologic prostheses to decrease rates of infection and prompt recognition with proper management is imperative.

Conclusions: Infections are decreasing in penile prosthetic surgery with advances in technology and surgical techniques. Modifiable risk factors should be evaluated and addressed whenever possible.

Keywords

Penile prosthesis Artificial urinary sphincter Infection Prosthetic surgery 

References

  1. 1.
    Mobley DF. Early history of inflatable penile prosthesis surgery: a view from someone who was there. Asian J Androl. 2015;17:225–9.PubMedGoogle Scholar
  2. 2.
    Scott FB, Bradley WE, Timm GW. Management of erectile impotence. Use of implantable inflatable prosthesis. Urology. 1973;2:80–2.PubMedGoogle Scholar
  3. 3.
    Hatzimouratidis K, et al. Guidelines on male sexual dysfunction: erectile dysfunction and premature ejaculation. Eur Urol. 2010;57:804–14.PubMedGoogle Scholar
  4. 4.
    Montague DK, et al. Chapter 1: the management of erectile dysfunction: an AUA update. J Urol. 2005;174:230–9.PubMedGoogle Scholar
  5. 5.
    Vakalopoulos I, et al. High patient satisfaction after inflatable penile prostheses implantation correlates with female partner satisfaction. J Sex Med. 2013;10:2774–81.PubMedGoogle Scholar
  6. 6.
    Carson CC. Diagnosis, treatment and prevention of penile prosthesis infection. Int J Impot Res. 2003;15(Suppl 5):S139–46.PubMedGoogle Scholar
  7. 7.
    Serefoglu EC, et al. Long-term revision rate due to infection in hydrophilic-coated inflatable penile prostheses: 11-year follow-up. J Sex Med. 2012;9:2182–6.PubMedGoogle Scholar
  8. 8.
    Wilson SK, Costerton JW. Biofilm and penile prosthesis infections in the era of coated implants: a review. J Sex Med. 2012;9:44–53.Google Scholar
  9. 9.
    Abouassaly R, Angermeier KW, Montague DK. Risk of infection with an antibiotic coated penile prosthesis at device replacement for mechanical failure. J Urol. 2006;176:2471–3.PubMedGoogle Scholar
  10. 10.
    Montague DK, Angermeier KW, Lakin MM. Penile prosthesis infections. Int J Impot Res. 2001;13:326–8.PubMedGoogle Scholar
  11. 11.
    Goetz A, Yu VL, O’Donnell WF. Surgical complications related to insertion of penile prostheses with emphasis on infection and cost. Infect Control Hosp Epidemiol. 1988;9:250–4.PubMedGoogle Scholar
  12. 12.
    Chason J, Sausville J, Kramer AC. Penile prosthesis implantation compares favorably in malpractice outcomes to other common urological procedures: findings from a malpractice insurance database. J Sex Med. 2009;6:2111–4.PubMedGoogle Scholar
  13. 13.
    Sunaryo PL, Colaco M, Terlecki R. Penile prostheses and the litigious patient: a legal database review. J Sex Med. 2014;11:2589–94.PubMedGoogle Scholar
  14. 14.
    Hellstrom WJG, et al. Implants, mechanical devices, and vascular surgery for erectile dysfunction. J Sex Med. 2010;7:501–23.PubMedGoogle Scholar
  15. 15.
    Selph JP, Carson CC 3rd. Penile prosthesis infection: approaches to prevention and treatment. Urol Clin North Am. 2011;38:227–35.PubMedGoogle Scholar
  16. 16.
    Mulcahy JJ. Long-term experience with salvage of infected penile implants. J Urol. 2000;163:481–2.PubMedGoogle Scholar
  17. 17.
    Mulcahy JJ. Penile prosthesis infection: progress in prevention and treatment. Curr Urol Rep. 2010;11:400–4.PubMedGoogle Scholar
  18. 18.
    Muench PJ. Infections versus penile implants: the war on bugs. J Urol. 2013;189:1631–7.PubMedGoogle Scholar
  19. 19.
    Blum MD. Infections of genitourinary prostheses. Infect Dis Clin N Am. 1989;3:259–74.Google Scholar
  20. 20.
    Mulcahy JJ. Current approach to the treatment of penile implant infections. Ther Adv Urol. 2010;2:69–75.PubMedPubMedCentralGoogle Scholar
  21. 21.
    Henry GD, et al. Penile prosthesis cultures during revision surgery: a multicenter study. J Urol. 2004;172:153–6.PubMedGoogle Scholar
  22. 22.
    von Eiff C, Heilmann C, Peters G. New aspects in the molecular basis of polymer-associated infections due to staphylococci. Eur J Clin Microbiol Infect. 1999;18:843–6.Google Scholar
  23. 23.
    Welliver RCJ, Hanerhoff BL, Henry GD, Kohler TS. Significance of biofilm for the prosthetic surgeon. Curr Urol Rep. 2014;15(411):411.PubMedGoogle Scholar
  24. 24.
    Arciola CR, Campoccia D, Speziale P, Montanaro L, Costerton JW. Biofilm formation in staphylococcus implant infections. A review of molecular mechanisms and implications for biofilm-resistant materials. Biomaterials. 2012;33:5967–82.PubMedGoogle Scholar
  25. 25.
    Cakan M, Demirel F, Karabacak O, Yalcinkaya F, Altug U. Risk factors for penile prosthetic infection. Int Urol Nephrol. 2003;35:209–13.PubMedGoogle Scholar
  26. 26.
    Gross MS, et al. The malleable implant salvage technique: infection outcomes after Mulcahy salvage procedure and replacement of infected inflatable penile prosthesis with malleable prosthesis. J Urol. 2016;195:694–7.PubMedGoogle Scholar
  27. 27.
    Wilson SK, Delk JR 2nd. Inflatable penile implant infection: predisposing factors and treatment suggestions. J Urol. 1995;153:659–61.PubMedGoogle Scholar
  28. 28.
    Minervini A, Ralph DJ, Pryor JP. Outcome of penile prosthesis implantation for treating erectile dysfunction: experience with 504 procedures. BJU Int. 2006;97:129–33.PubMedGoogle Scholar
  29. 29.
    Jarow JP. Risk factors for penile prosthetic infection. J Urol. 1996;156:402–4.PubMedGoogle Scholar
  30. 30.
    Bishop JR, et al. Use of glycosylated hemoglobin to identify diabetics at high risk for penile periprosthetic infections. J Urol. 1992;147:386–8.PubMedGoogle Scholar
  31. 31.
    Diokno AC, Sonda LP. Compatibility of genitourinary prostheses and intermittent self-catheterization. J Urol. 1981;125:659–60.PubMedGoogle Scholar
  32. 32.
    Dietzen CJ, Lloyd LK. Complications of intracavernous injections and penile prostheses in spinal cord injured men. Arch Phys Med Rehabil. 1992;73:652–5.PubMedGoogle Scholar
  33. 33.
    Balen A, Gross MS, Phillips EA, Henry GD, Munarriz R. Active polysubstance abuse concurrent with surgery as a possible newly identified infection risk factor in inflatable penile prosthesis placement based on a retrospective analysis of health and socioeconomic factors. J Sex Med. 2016;13:697–701.PubMedGoogle Scholar
  34. 34.
    Sidi AA, Peng W, Sanseau C, Lange PH. Penile prosthesis surgery in the treatment of impotence in the immunosuppressed man. J Urol. 1987;137:681–2.PubMedGoogle Scholar
  35. 35.
    Guild GN, Moore TJ, Barnes W, Hermann C. CD4 count is associated with postoperative infection in patients with orthopaedic trauma who are HIV positive. Clin Orthop. 2012;470:1507–12.PubMedGoogle Scholar
  36. 36.
    Kavoussi NL, et al. Are urine cultures necessary prior to urologic prosthetic surgery? Sex Med Rev. 2018;6:157–61.PubMedGoogle Scholar
  37. 37.
    Kavoussi NL, et al. Preoperative urine culture results correlate poorly with bacteriology of urologic prosthetic device infections. J Sex Med. 2017;14:163–8.PubMedGoogle Scholar
  38. 38.
    Habous M, et al. Defining a glycated haemoglobin (HbA1c) level that predicts increased risk of penile implant infection. BJU Int. 2018;121:293–300.PubMedGoogle Scholar
  39. 39.
    Bode LGM, et al. Preventing surgical-site infections in nasal carriers of staphylococcus aureus. N Engl J Med. 2010;362:9–17.PubMedGoogle Scholar
  40. 40.
    Webster J, Osborne S. Preoperative bathing or showering with skin antiseptics to prevent surgical site infection. Cochrane Database Syst Rev. 2015:CD004985.  https://doi.org/10.1002/14651858.CD004985.pub5.
  41. 41.
    Tanner J, Norrie P, Melen K. Preoperative hair removal to reduce surgical site infection. Cochrane Database Syst Rev. 2011:CD004122.  https://doi.org/10.1002/14651858.CD004122.pub4.
  42. 42.
    Grober ED, Domes T, Fanipour M, Copp JE. Preoperative hair removal on the male genitalia: clippers vs. razors. J Sex Med. 2013;10:589–94.Google Scholar
  43. 43.
    Sexual Medicine Society of North America. Razors and preoperative preparation of the male genitalia. SMSNA - Position Statements. http://www.smsna.org/V1/about/position-statements.
  44. 44.
    Wolf JSJ, et al. Best practice policy statement on urologic surgery antimicrobial prophylaxis. J Urol. 2008;179:1379–90.PubMedGoogle Scholar
  45. 45.
    Gross MS, et al. Multicenter investigation of the micro-organisms involved in penile prosthesis infection: an analysis of the efficacy of the AUA and EAU guidelines for penile prosthesis prophylaxis. J Sex Med. 2017;14:455–63.PubMedGoogle Scholar
  46. 46.
    Bratzler DW, Houck PM. Antimicrobial prophylaxis for surgery: an advisory statement from the National Surgical Infection Prevention Project. Am J Surg. 2005;189:395–404.PubMedGoogle Scholar
  47. 47.
    Parienti JJ, et al. Hand-rubbing with an aqueous alcoholic solution vs traditional surgical hand-scrubbing and 30-day surgical site infection rates: a randomized equivalence study. JAMA. 2002;288:722–7.PubMedGoogle Scholar
  48. 48.
    Centers for Disease Control and Prevention. Guideline for prevention of surgical site infection. 2017. CDC Guideline Library. https://www.cdc.gov/infectioncontrol/guidelines/ssi/index.html.
  49. 49.
    Tanner J, Parkinson H. Double gloving to reduce surgical cross-infection. Cochrane Database Syst Rev. 2006:CD003087.  https://doi.org/10.1002/14651858.CD003087.pub2.
  50. 50.
    Greif R, Akca O, Horn EP, Kurz A, Sessler DI. Supplemental perioperative oxygen to reduce the incidence of surgical-wound infection. N Engl J Med. 2000;342:161–7.PubMedGoogle Scholar
  51. 51.
    Kurz A, Sessler DI, Lenhardt R. Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. Study of wound infection and temperature group. N Engl J Med. 1996;334:1209–15.PubMedGoogle Scholar
  52. 52.
    Darouiche RO, et al. North American consensus document on infection of penile prostheses. Urology. 2013;82:937–42.PubMedGoogle Scholar
  53. 53.
    Yeung LL, Grewal S, Bullock A, Lai HH, Brandes SB. A comparison of chlorhexidine-alcohol versus povidone-iodine for eliminating skin flora before genitourinary prosthetic surgery: a randomized controlled trial. J Urol. 2013;189:136–40.PubMedPubMedCentralGoogle Scholar
  54. 54.
    Darouiche RO, et al. Chlorhexidine-alcohol versus povidone-iodine for surgical-site antisepsis. N Engl J Med. 2010;362:18–26.Google Scholar
  55. 55.
    Mandava SH, Serefoglu EC, Freier MT, Wilson SK, Hellstrom WJG. Infection retardant coated inflatable penile prostheses decrease the incidence of infection: a systematic review and meta-analysis. J Urol. 2012;188:1855–60.PubMedGoogle Scholar
  56. 56.
    Eid JF. No-touch technique. J Sex Med. 2011;8:5–8.PubMedGoogle Scholar
  57. 57.
    Eid JF, Wilson SK, Cleves M, Salem EA. Coated implants and ‘no touch’ surgical technique decreases risk of infection in inflatable penile prosthesis implantation to 0.46%. Urology. 2012;79:1310–5.PubMedPubMedCentralGoogle Scholar
  58. 58.
    Garber BB, Marcus SM. Does surgical approach affect the incidence of inflatable penile prosthesis infection? Urology. 1998;52:291–3.PubMedGoogle Scholar
  59. 59.
    Sahni NR, Dalton M, Cutler DM, Birkmeyer JD, Chandra A. Surgeon specialization and operative mortality in United States: retrospective analysis. BMJ. 2016;354:i3571.PubMedPubMedCentralGoogle Scholar
  60. 60.
    Henry GD, et al. Centers of excellence concept and penile prostheses: an outcome analysis. J Urol. 2009;181:1264–8.PubMedGoogle Scholar
  61. 61.
    Henry GD. The Henry mummy wrap and the Henry finger sweep surgical techniques. J Sex Med. 2009;6:619–22.PubMedPubMedCentralGoogle Scholar
  62. 62.
    Sadeghi-Nejad H, et al. Multi-institutional outcome study on the efficacy of closed-suction drainage of the scrotum in three-piece inflatable penile prosthesis surgery. Int J Impot Res. 2005;17:535–8.PubMedPubMedCentralGoogle Scholar
  63. 63.
    Henry GD, et al. Revision washout decreases penile prosthesis infection in revision surgery: a multicenter study. J Urol. 2005;173:89–92.PubMedGoogle Scholar
  64. 64.
    Habous M, et al. Conservative therapy is an effective option in patients with localized infection after penile implant surgery. J Sex Med. 2016;13:972–6.PubMedPubMedCentralGoogle Scholar
  65. 65.
    Brant MD, Ludlow JK, Mulcahy JJ. The prosthesis salvage operation: immediate replacement of the infected penile prosthesis. J Urol. 1996;155:155–7.PubMedGoogle Scholar
  66. 66.
    Zargaroff S, et al. National trends in the treatment of penile prosthesis infections by explantation alone vs. immediate salvage and reimplantation. J Sex Med. 2014;11:1078–85.PubMedGoogle Scholar
  67. 67.
    Scott FB, Bradley WE, Timm GW. Treatment of urinary incontinence by an implantable prosthetic urinary sphincter. J Urol. 1974;112:75–80.PubMedGoogle Scholar
  68. 68.
    Pederzoli F, et al. Analysis of hospital readmissions after prosthetic urologic surgery in the United States: nationally representative estimates of causes, costs, and predictive factors. J Sex Med. 2017;14:1059–65.PubMedGoogle Scholar
  69. 69.
    Marks JL, Light JK. Management of urinary incontinence after prostatectomy with the artificial urinary sphincter. J Urol. 1989;142:302–4.PubMedGoogle Scholar
  70. 70.
    Gundian JC, Barrett DM, Parulkar BG. Mayo Clinic experience with use of the AMS800 artificial urinary sphincter for urinary incontinence following radical prostatectomy. J Urol. 1989;142:1459–61.PubMedGoogle Scholar
  71. 71.
    Bordenave M, et al. Long-term results of the treatment of urinary incontinence with bulbar implantation of artificial urinary sphincter in men: a single-center experience. Progres En Urol J Assoc Francaise Urol Soc Francaise Urol. 2011;21:277–82.Google Scholar
  72. 72.
    Montague DK, Angermeier KW. Postprostatectomy urinary incontinence: the case for artificial urinary sphincter implantation. Urology. 2000;55:2–4.PubMedGoogle Scholar
  73. 73.
    Ostrowski I, et al. Multicentre experience with ZSI 375 artificial urinary sphincter for the treatment of stress urinary incontinence in men. Urologia. 2017;84:148–52.PubMedGoogle Scholar
  74. 74.
    Llorens C, Pottek T. Urinary artificial sphincter ZSI 375 for treatment of stress urinary incontinence in men: 5 and 7 years follow-up report. Urologia. 2017;84:263–6.PubMedGoogle Scholar
  75. 75.
    Miller AR, Linder BJ, Rangel LJ, Yang DY, Elliott DS. The impact of incontinence etiology on artificial urinary sphincter outcomes. Investig Clin Urol. 2017;58:241–6.PubMedPubMedCentralGoogle Scholar
  76. 76.
    Husch T, et al. Antibiotic coating of the artificial urinary sphincter (AMS 800): is it worthwhile? Urology. 2017;103:179–84.PubMedGoogle Scholar
  77. 77.
    Lai HH, Hsu EI, Teh BS, Butler EB, Boone TB. 13 years of experience with artificial urinary sphincter implantation at Baylor College of Medicine. J Urol. 2007;177:1021–5.PubMedGoogle Scholar
  78. 78.
    Kim SP, et al. Long-term durability and functional outcomes among patients with artificial urinary sphincters: a 10-year retrospective review from the University of Michigan. J Urol. 2008;179:1912–6.PubMedGoogle Scholar
  79. 79.
    Raj GV, Peterson AC, Toh KL, Webster GD. Outcomes following revisions and secondary implantation of the artificial urinary sphincter. J Urol. 2005;173:1242–5.PubMedGoogle Scholar
  80. 80.
    Sacomani CAR, et al. Long-term results of the implantation of the AMS 800 artificial sphincter for post-prostatectomy incontinence: a single-center experience. Int Braz J Urol Off J Braz Soc Urol. 2018;44:114–20.Google Scholar
  81. 81.
    Linder BJ, de Cogain M, Elliott DS. Long-term device outcomes of artificial urinary sphincter reimplantation following prior explantation for erosion or infection. J Urol. 2014;191:734–8.PubMedGoogle Scholar
  82. 82.
    Serag H, Bang S, Almallah YZ. Artificial urinary sphincters for treating postprostatectomy incontinence: a contemporary experience from the UK. Res Rep Urol. 2018;10:63–8.PubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Lael Reinstatler
    • 1
  • Ricardo M. Munarriz
    • 2
  • Martin S. Gross
    • 1
  1. 1.Section of UrologyDartmouth-Hitchcock Medical CenterLebanonUSA
  2. 2.Boston University Medical CenterBostonUSA

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