Conservative Therapy is an Effective Option in Patients with Localized Infection After Penile Implant Surgery

• DOI: 10.1016/j.jsxm.2016.04.064
• Publication Date: 2016-05-07T19:58:00Z
• Authors: Mohamad Habous; Mohammed Farag; Ben Williamson; Osama Laban; Saad Mahmoud; Osama Abdelwahab; Mohamed Elkhouly; Usama Kamil; Saleh Binsaleh; Raanan Tal; David Ralph; John P. Mulhall
• Keywords: Penile prosthesis

ABSTRACT

Introduction Traditionally, penile implant (PI) infections have been managed by removal with immediate or delayed replacement. Recently, interest has been focused on conservative therapy (CT) using antibiotic therapy.

Aim To investigate the success rate and predictive factors affecting the outcome of CT in PI infection patients.

Methods Patients diagnosed with early, localized PI infection were considered candidates for CT. Exclusion criteria included temperature >37.5°C, WBC >13,000/μL, and appearance of any sign of sepsis. In patients with purulent drainage, culture swabs were taken and an antibiotic was chosen based on sensitivity results. Oral antibiotics were used until the local infection was completely resolved. Patients were evaluated weekly during this process.

Results Thirty-seven patients were retrospectively reviewed and constituted the study population. Mean age was 58.1 (range 37–85; SD 9.9) years. All were diabetic. Mean BMI was 31.8 (range 24–47; SD 5.0). PI was malleable in 33 cases and inflatable in 4 cases. Culture results (n = 19) included Staphylococcus epidermidis (42 %), pseudomonas (21%), Escherichia coli (21%), and S aureus (16%). Four of 37 patients needed the PI removed due to CT failure and onset of systemic symptoms, at a mean time-point of 75 ± 1.8 days after CT commencement. In men who were cured, mean time to complete healing was 49 (range 29–97; SD 15.8) days. Two of 37 patients (5%) had PI removal because of persistent penile pain despite complete wound healing, at a mean time point of 128 ± 2.5 days after CT commencement. All men managed conservatively resumed sexual intercourse.

Conclusion CT of localized PI infection appears to be a viable option for such patients, with the majority of patients retaining their implant and resuming sexual activity.