Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Review Article
  • Published:

Penile implant infection part 3: the changing spectrum of treatment

International Journal of Impotence Research volume 35, pages 512–518 (2023)Cite this article

Subjects

Abstract

Penile prosthesis infection remains a rare but devastating complication of implantation. Historically, management of device infection was always extirpation. While certainly effective, device removal leaves an unhappy patient with a shortened penis. In this last part of a three-part series on the topic of penile prosthesis infection, we seek to highlight new and emerging ideas of infection management which have allowed surgeons the option of preserving the implanted status in select patients.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on SpringerLink
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Wound dehiscence.
Fig. 2: Presentations for device Infection.
Fig. 3: Salvage washout for infection.

Similar content being viewed by others

References

  1. Holloway FB, Farah RN. Intermediate term assessment of the reliability, function and patient satisfaction with the AMS700 Ultrex penile prosthesis. J Urol. 1997;157:1687–91.

    Article  CAS  PubMed  Google Scholar 

  2. Köhler TS, Wen L, Wilson SK. Penile implant device infection part 1: fact or fiction. Int J Impot Res. 2020. online ahead of print.

  3. Mulcahy JJ, Köhler TS, Wen L, Wilson SK. Penile implant infections part 2: infection retardant coatings have changed the game. Int J Impot Res. 2020. online ahead of print.

  4. Wilson SK, Costerton W. Biofilm and penile prosthesis infections in the era of coated implants: a review. J Sex Med. 2012;9:44–53.

    Article  PubMed  Google Scholar 

  5. Wolter CE, Hellstrom WJ. The hydrophilic-coated inflatable penile prosthesis: 1-year experience. J Sex Med. 2004;1:221–4.

    Article  PubMed  Google Scholar 

  6. Kava BR, Kanagarajah P, Ayyathurai P. Contemporary revision penile prosthesis surgery is not associated with a high risk of implant colonization or infection: a single-surgeon series. J Sex Med. 2011;8:1540–6.

    Article  PubMed  Google Scholar 

  7. Mulcahy JJ. Current approach to the treatment of penile implant infections. Ther Adv Urol. 2010;2:69–75.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Kim JC, Lunati FP, Khan SA, Waltzer WC. T-tube drainage of infected penile corporeal chambers. Urology. 1995;45:514–5.

    Article  CAS  PubMed  Google Scholar 

  9. Maatman TJ, Montague DK. Intracorporeal drainage after removal of infected penile prostheses. Urology. 1984;23:184–5.

    Article  CAS  PubMed  Google Scholar 

  10. Lopategui DM, Balise RR, Bouzoubaa LA, Wilson SK, Kava BR. The impact of immediate salvage surgery on corporeal length preservation in patients presenting with penile implant infections. J Urol. 2018;200:171–7.

    Article  PubMed  Google Scholar 

  11. Canguven O, Talib RA, Campbell J, De Young L, El Ansari W, Al-Ansari A. Is the daily use of vacuum erection device for a month before penile prosthesis implantation beneficial? a randomized controlled trial. Andrology. 2017;5:103–6.

    Article  CAS  PubMed  Google Scholar 

  12. Köhler TK, Gupta NK, Wilson SK. Wilson’s pearls perils and pitfalls of penile prosthesis surgery. Fort Smith AR: Calvert McBride; 2018.

  13. Wilson SK, Simhan J Gross M. Cylinder insertion into scarred corporal bodies: prosthetic urology’s most difficult challenge. Int J Impot Res. 2020. online ahead of print.

  14. Caire AA, Boonjindasup A, Hellstrom WJ. Does a replacement or revision of an inflatable penile prosthesis lead to decreased patient satisfaction? Int J Impot Res. 2011;23:39–42.

    Article  CAS  PubMed  Google Scholar 

  15. Silverstein AD, Henry GD, Evans B, Pasmore M, Simmons CJ, Donatucci CF. Biofilm formation on clinically noninfected penile prostheses. J Urol. 2006;176:1008–11.

    Article  PubMed  Google Scholar 

  16. Darouiche RO, Bell AJ, Boone TB, Brock G, Broderick GA, Burnett AL, et al. North American consensus document on infection of penile prostheses. Urology. 2013;82:937–42.

    Article  PubMed  Google Scholar 

  17. Olds C, Spataro E, Li K, Kandathil C, Most SP. Postoperative antibiotic use among patients undergoing functional facial plastic and reconstructive surgery. JAMA Facial Plast Surg. 2019;21:491–7.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Gupta NK, Sulaver R, Welliver C, Kottwitz M, Frederick L, Dynda D, et al. Scrotoplasty at time of penile implant is at high risk for dehiscence in diabetics. Sex Med. 2019;4:602–8.

    Article  Google Scholar 

  19. Henry GD, Price G, Pryor M, Greenfield J, Jones L, Perito P, et al. Observation of local clinical penile prostheses infections instead of immediate salvage rescue/removal: multicenter study with surprising results; Abstract: PD20-04. J Urol. 2014;191 Supplement: E612–3.

    Google Scholar 

  20. Habous M, Farag M, Williamson B, Laban O, Mahmoud S, Abdelwahab O, et al. Conservative therapy is effective option in patients with localized infection after penile implant surgery. Sex Med. 2016;1:972–6.

    Article  Google Scholar 

  21. Cotta BH, Butcher M, Welliver C, McVary K, Köhler T. Two fungal infections of inflatable penile prostheses in diabetics. Sex Med. 2015;4:339.

    Article  Google Scholar 

  22. Rezaee ME, Towe M, Osman MM, Huynh LM, El-Khatib FM, Andrianne R, 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.

    Article  Google Scholar 

  23. Mulcahy JJ. Long-term experience with salvage of infected penile implants. J Urol. 2000;163:481–2.

    Article  CAS  PubMed  Google Scholar 

  24. Brant MD, Ludlow JK, Mulcahy JJ. The prosthesis salvage operation: immediate replacement of the infected penile prosthesis. J Urol. 1996;155:155–7.

    Article  CAS  PubMed  Google Scholar 

  25. Knoll LD. Penile prosthetic infection: management by delayed and immediate salvage techniques. Urology. 1998;52:287–90.

    Article  CAS  PubMed  Google Scholar 

  26. Bryan DE, Mulcahy JJ, Simmons GR. Salvage procedure for infected noneroded artificial urinary sphincters. J Urol. 2002;168:2464–6.

    Article  PubMed  Google Scholar 

  27. Pan S, Rodriguez D, Thirumavalavan N, Gross MS, Eid JF, Mulcahy J, et al. The use of antiseptic solutions in the prevention and management of penile prosthesis infections: a review of the cytotoxic and microbiological effects of common irrigation solutions. J Sex Med. 2019;16:781–90.

    Article  PubMed  Google Scholar 

  28. Manka MG, Yang D, Andrews J, Chalmers B, Hebert K, Köhler TS, Trost L. Intraoperative use of Betadine irrigation is associalted with 9-fold increased liklihood of penile prosthesis infection: results from a retrospective case controled study. J Sex Med. 2020;8:422–7.

    Article  Google Scholar 

  29. Zargaroff S, Sharma V, Berhanu D, Pearl JA, Meeks JJ, Dupree JM, 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.

    Article  PubMed  Google Scholar 

  30. Gross MS, Phillips EA, Balenm A, Eid JF, Yang C, Simon R, 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.

    Article  PubMed  Google Scholar 

  31. Parsons CL, Stein PC, Dobke MK, Virden CP, Frank DH. Diagnosis and therapy of subclinically infected prostheses. Surg Gynecol Obstet. 1993;177:504–6.

    CAS  PubMed  Google Scholar 

  32. Lujan S, Rogel R, Broseta E, Boronat F. local treatment of penile prosthesis infection as alternative to immediate salvage surgery. Sex Med. 2016;4:e255–8.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Henry GD, Wilson SK, Delk JR, Carson CC, Silverstein A, Cleves MA, et al. Penile prosthesis cultures during revision surgery: a multicenter study. J Urol. 2004;172:153–6.

    Article  PubMed  Google Scholar 

  34. Henry GD, Wilson SK, Delk JR, Carson CC, Wiygul J, Tornehi C, et al. Revision washout decreases penile prosthesis infection in revision surgery: a multicenter study. J Urol. 2005;173:89–92.

    Article  PubMed  Google Scholar 

  35. Kohler TS, Modder JK, Dupree JM, Bush NC, McVary KT. Malleable implant substitution for the management of penile prosthesis pump erosion: a pilot study. J Sex Med. 2009;6:1474–8.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Urology, Mayo Clinic, Rochester, MN, USA

    Tobias S. Köhler & Lexiaochuan Wen

  2. Department of Urology, Institute for Urologic Excellence, La Quinta, CA, USA

    Steven K. Wilson

Authors
  1. Tobias S. Köhler
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lexiaochuan Wen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Steven K. Wilson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tobias S. Köhler.

Ethics declarations

Conflict of interest

TSK: Consultant Boston Scientific and Coloplast. LW: Nothing to declare. SKW: Consultant AMT, Coloplast, International Medical Devices. Lecturer Boston Scientific.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Köhler, T.S., Wen, L. & Wilson, S.K. Penile implant infection part 3: the changing spectrum of treatment. Int J Impot Res 35, 512–518 (2023). https://doi.org/10.1038/s41443-020-00382-8

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41443-020-00382-8

This article is cited by

Search

Advanced search

Quick links