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A multicenter investigation examining timing of penile prosthesis infection management and responsible organisms

International Journal of Impotence Research volume 36, pages 214–217 (2024)Cite this article

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Abstract

The purpose of this investigation was to examine the timing of penile prosthesis infection management by different responsible organisms. A retrospective cohort study was performed of patients who underwent penile prosthesis salvage or explant procedures due to a suspected infection between 2001 and 2018. The cohort consisted of 216 patients from 33 different facilities and six countries. The most common primary organisms responsible for device infections included, Gram-positives (31.5%), no growth cultures (30.6%), Gram-negatives (22.2%), fungal (11.6%), and anaerobic organisms (4.2%). Overall, median time to infection was 1.8 (interquartile range [IQR]: 1.0–3.0) months for all patients. Median time to infection management was similar between responsible organisms: 1.0 (IQR: 1.0–2.3) months for Gram-negatives and 2 months for Gram-positives (IQR: 1.0–1.4), fungal (IQR: 1.0–5.0), anaerobes (IQR: 1.0–2.5), and no growth cultures (IQR: 1.0–3.0, p = 0.56). Median time to infection management was significantly shorter among patients who received aminoglycoside/vancomycin prophylaxis (1.5 months, IQR: 1.0–2.5, p < 0.01) compared to other antibiotic groups. Median time to infection management was significantly longer for patients managed with a three-piece inflatable implant salvage procedure (2.8 months, IQR: 1.0–5.0, p = 0.02) compared to other salvage procedures. Conventional wisdom surrounding early versus late penile prosthesis infections should largely be abandoned. More than half of penile prosthesis infections are surgically managed within 2 months of initial device placement.

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Fig. 1: Distribution of organisms responsible for penile prosthesis infections.
Fig. 2: Time to infection management by responsible organism group.
Fig. 3: Time to infection management by pre-operative antibiotic regimen.

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The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We would like to acknowledge the following centers for contributing data to this project, including Johns Hopkins Hospital, Boston Medical Center, University of Buenos Aires, Rush University Medical Center, Urology Associates of North Texas, Hackensack University Medical Center, University of Texas McGovern Medical School, Mayo Clinic, Dartmouth-Hitchcock Medical Center, University Hospital of Liege, University College Hospital, Institute Medico Rosello, Nova Southeastern University, Perito Urology, Medical College of Wisconsin, Advanced Urological Care, Regional Urology, Mount Sinai Hospital, Albert Einstein College, Columbia University College of Physicians & Surgeons, NYU Lagone Medical Center, Yale School of Medicine, University of California, Irvine Medical Center, Hahnemann University Hospital, University of Utah Hospital, Sewum Prosthetic Urology Center of Excellence, SIU School of Medicine, Faculdade de Medicina do ABC/Instituto H. Ellis, and USF Morsani College of Medicine. This project did not receive funding.

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Authors and Affiliations

  1. The Brady Urological Institute, Johns Hopkins Medicine, 600 N Wolfe Street, Baltimore, MD, 21287, USA

    Michael E. Rezaee

  2. Department of Urology, Boston University Medical Center, 725 Albany St, 3rd Floor, Suite B, Boston, MA, 02118, USA

    Amanda R. Swanton & Ricardo M. Munarriz

  3. Section of Urology, Department of Surgery, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH, 03756, USA

    Martin S. Gross

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Contributions

MR—Contributed equally to study design, data collection, data analysis, data interpretation, and manuscript development. AS—Contributed equally to study design, data collection, data analysis, data interpretation, and manuscript development. MG—Contributed equally to study design, data collection, data analysis, data interpretation, and manuscript development. RM—Contributed equally to study design, data collection, data analysis, data interpretation, and manuscript development.

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Correspondence to Michael E. Rezaee.

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MG and RM are consultants for Coloplast.

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Rezaee, M.E., Swanton, A.R., Gross, M.S. et al. A multicenter investigation examining timing of penile prosthesis infection management and responsible organisms. Int J Impot Res 36, 214–217 (2024). https://doi.org/10.1038/s41443-022-00659-0

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