Abstract
Urologic implant revision carries a higher infection risk than virgin implantation. Historically, exchanging device components at the time of revision was performed to reduce infection risk. We hypothesize that revision without replacement of any parts of the device may not be associated with increased infection risk. A single-center, retrospective cohort study was performed on patients undergoing urologic implant revision from 2000 to 2021. Revisions involving exchange of any/all device components (+CE) were compared to revisions without exchange of any components (−CE). The primary outcome was infection or erosion within 12 weeks of revision. Infection rates were compared using Fischer exact test. Infection-free survival (IFS) was compared with Kaplan-Meier (KM) log-rank test and Cox proportional hazards (CPH) model. 551 revisions were included, including 497 revisions with CE and 54 without CE. Among those with at least 12 weeks follow-up, no difference was seen in infection rates within 12 weeks of revision [−CE 3/39 (7.7%) vs. +CE 10/383 (2.6%)], p = 0.109). In addition, IFS was comparable between groups (log-rank test p = 0.22, HR for −CE 1.65 (0.65–4.21). Revision surgery for IPP or AUS without CE may not present an elevated risk of infection in the properly selected patient.
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Data availability
Raw data for this project is contained in an IRB approved database at Duke University Medical Center. This data can be made available upon request to Scott Campbell, MD at scott.p.campbell@duke.edu.
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ACL designed the study and edited the paper. SPC created the database, collected data, performed data analysis, and assisted with paper writing and editing. CJK collected data and assisted with paper writing and editing. AA collected data and assisted with paper writing and editing. BMI, LAI, ZRD assisted with paper editing.
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ACL is a consultant and speaker for Boston Scientific and Coloplast.
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Campbell, S.P., Kim, C.J., Allkanjari, A. et al. Infection rates following urologic prosthetic revision without replacement of any device components compared to partial or complete device exchange: a single-center retrospective cohort study. Int J Impot Res 35, 725–730 (2023). https://doi.org/10.1038/s41443-022-00616-x
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DOI: https://doi.org/10.1038/s41443-022-00616-x
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