Abstract: PD25-03
Sources of Funding: None

Introduction

Primary care providers (PCPs) harbor misconceptions regarding penile prosthetic surgery, largely overestimating the rate of infection. Additionally, men in the community may fear operations involving surgeons-in-training. Rates of infection following surgery for primary placement and revision of inflatable penile prostheses (IPP) is estimated as 1-3% and 10-18%, respectively. Our objective was to determine the contemporary incidence of infection following IPP surgery at an academic training center.

Methods

Review of a prospectively collected single-surgeon database was performed. All cases of IPP placement from January 2011 to November 2016 were reviewed. Information regarding training level of assistant surgeon(s) was collected, and follow-up data was compiled regarding postoperative infections and need for revision surgery. Cases involving total synthetic corporal reconstruction were excluded.

Results

246 cases meeting inclusion criteria were identified. Mean patient age was 64.5 years, and mean follow-up was 28 months. Distribution involved 205 (83%) for primary placement, 37 (15%) for removal/replacement, and 4 (2%) in setting of prior device removal. Diabetes was noted in 29% of men. Trainee involvement was noted in 100% of cases. Rates of involvement by postgraduate year (PGY) were 81 (PGY2 or lower), 23 (PGY3), 12 (PGY4), 113 (PGY5), 112 (PGY6). Two operations were performed for suspected infection, one based on pain and one based on fever of unknown origin. Both were without intraoperative evidence of infection and all operative cultures were negative. One received simple removal/replacement and the other received removal with subsequent finding of pulmonary source for fever. Thus, the postoperative infection rate in this series was 0%.

Conclusions

In this contemporary series from an academic training center, infection following IPP surgery is uncommon, even with 100% involvement of surgeons-in-training. This data should be used to better inform PCPs and members of the general public potentially interested in restoration of sexual function. Fear of involving residents in IPP surgery appears to be unwarranted.

Funding

None