Abstract: PD22-08
Sources of Funding: None

Introduction

Infection-retardant coatings on penile implants have significantly reduced the incidence of device infections. The coatings primarily target coagulase- negative Staphylococcus species. Traditionally, these organisms have been implicated in the majority of implant infections. We desired to ascertain the spectrum of bacterial species responsible for implant infections in the era following the widespread adoption of infection-retardant coated devices

Methods

The study cohort was derived from two prospective databases of patients undergoing penile implant surgery from two high- volume centers between February, 2004 and July, 2016. Included were those patients undergoing primary implant placement, revision surgery, and external referrals for management of an infected implant. Descriptive data included: patient age, comorbidities, first-time or revision surgery, and the organisms causing infection. Over the last 10 years, both centers have pursued an aggressive policy of performing salvage surgery. Patients who are not candidates for salvage surgery include those with systemic toxicity, purulence, cellulitis, a systemic inflammatory response, and significant soft tissue or urethral destruction.

Results

The cohort consisted of 39 patients, including 12 (2.8%) infections following 430 primary implant surgeries, 20 (5.5%) infections following 365 revision surgeries and 6 patients with infected implants referred from external sources (3 primary and 3 revision). Average patient age was 64.2 +/- 6.7 years. Table 1 depicts the spectrum of organisms encountered. . There were no differences between the groups in terms of comorbidities. Based upon the criteria above, only 18 (46%) patients were candidates for salvage surgery, of which 12 (67%) were successful.

Conclusions

The spectrum of bacterial species causing penile implant infections has changed in the era of infection-retardant coated devices. Contemporary infections are much more likely to be caused by Staph. aureus, and nearly 50% of infections are caused by gram negative bacteria. The aggressive nature of these bacteria limits the number of patients who are candidates for salvage surgery, and reduces the likelihood of an infected patient undergoing successful salvage surgery.

Funding

None