Login to Access Video or Poster Abstract: MP25-10
Sources of Funding: None

Introduction

Inflatable penile prosthesis (IPP) remains the gold standard for refractory erectile dysfunction (ED). Despite ongoing improvements, infectious complications remain a significant concern in IPP revision surgery. We therefore sought to evaluate the impact of number of IPPs and IPP surgeries on subsequent infection rates.

Methods

A retrospective analysis was performed of all men presenting to a tertiary referral center for consideration of IPP revision or salvage surgery between 2013 & 2015. Demographic and clinical features were reviewed, including number of prior IPPs, reason for evaluation, and rate, number, and timing of IPP infections. Statistical analyses were performed to evaluate associations between number of IPP related surgeries and device placements and resultant infectious complications.

Results

A total of 44 men (median age 69; range 50, 88) were identified with at least one prior IPP. The most common reason for presentation was malfunction (52%, 23/44), followed by infection with device removal (23%, 10/44). Prior surgeries were performed at various facilities, representing a geographically diverse surgical cohort. Overall, the risk of subsequent device infection at revision surgery was strongly correlated and increased linearly based on the number of prior IPPs: 1 prior IPP (6.8%; 3/44), 2 prior (18.2%; 4/22), 3 prior (33.3%; 4/12), 4 prior (50%; 4/8), and 5 prior (100%; 2/2) (R²=0.90, p=0.01). Similarly, rates of infection positively correlated with number of prior IPP-related surgeries performed (R²=0.97, p<0.01). Freedom from an episode of IPP infection decreased with number of IPP devices and procedures performed. The median time to development of infection after most recent IPP surgery was 2 months (IQR 1-3.3 months). No clinical or demographic differences were identified between the infection and non-infection cohorts, including age, DM status, tobacco usage, Charleston Comorbidity Index score, prior prostatectomy, prior hernia repair, or Peyronie&[prime]s disease.

Conclusions

Infection rates of revision/salvage IPP surgery increase with each subsequent IPP placement or following IPP-related surgeries. The majority of patients experience at least one infection by their 4th device. This data could provide relevant information necessary for appropriate patient counseling.

Funding

None