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Intraoperative use of vancomycin paste during penile prosthesis placement: initial outcomes

International Journal of Impotence Research volume 34, pages 81–85 (2022)Cite this article

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Abstract

Penile prosthesis implantation is a safe and effective treatment option in the management of erectile dysfunction, associated with high satisfaction and low complication rates. Infection is a rare complication (0.5–3%), but devastating for the patient and surgeon when it occurs. Adapting from other surgical disciplines, we have utilized vancomycin paste to provide prolonged focal antibiotic exposure around the penile prosthesis pump, a site prone to infection. The aim of this study is to determine the safety and efficacy of intraoperative vancomycin paste with regards to infection prevention during penile prosthesis placement. This is a multi-institutional nonrandomized retrospective IRB-approved study comparing patients who underwent placement of a primary inflatable penile prosthesis with intraoperative vancomycin paste to those without. Primary outcomes included pump fibrosis, infection, erosion, hematoma, and complete device malfunction. From April 2019 to October 2019, two surgeons utilized vancomycin paste intraoperatively during virginal penile prosthesis surgery on 90 patients, whose mean age was 60 years. These patients were compared to an historical control group that included 166 patients, also with a mean age of 60 years, who underwent the same penile prosthesis surgery between 2014 and 2017 without the paste. Among the intervention group, the overall complication rate was 1.1%, due to a scrotal hematoma. Ultimately, there was no statistically significant difference in infection rate (0% in both groups) or overall complication rate (1.1% in the intervention group compared to 1.2% in the control group). The use of vancomycin paste appears to be safe, however future prospective studies are needed to determine its efficacy in infection prevention.

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Fig. 1: Creation of Vancomycin paste.

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Authors and Affiliations

  1. Boston University Medical Center, Boston, MA, USA

    Priyanka Bearelly, Maria D’Amico & Ricardo Munarriz

  2. NorCal Urology Medical Group, Oakland, CA, USA

    Shu Pan

  3. Case Western Reserve University School of Medicine, Cleveland, OH, USA

    Nannan Thirumavalavan

  4. Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA

    Martin S. Gross

  5. Albert Einstein College of Medicine, New York City, NY, USA

    Pedro Maria

Authors
  1. Priyanka Bearelly
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  2. Maria D’Amico
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  3. Shu Pan
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  4. Nannan Thirumavalavan
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  5. Martin S. Gross
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  6. Pedro Maria
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  7. Ricardo Munarriz
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Correspondence to Ricardo Munarriz.

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RM, PM, and MG are consultants for Coloplast.

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Bearelly, P., D’Amico, M., Pan, S. et al. Intraoperative use of vancomycin paste during penile prosthesis placement: initial outcomes. Int J Impot Res 34, 81–85 (2022). https://doi.org/10.1038/s41443-020-00368-6

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