Management of the Infected Penile Prostheses

Kim, Hyun Woo; Kim, Sae Chul

Abstract

Infection of the prosthesis remains a significant complication that almost always results in loss of the device. From 1983 through 1993, 290 penile prostheses have been placed at our hospital. Among them 13(4.5% ) required removal of the prosthesis secondary to gross infection and 8 underwent reimplantation. The infection rates were higher in diabetogenic impotence( 7.9%) than in nondiabetogenic ( 4.0% ) and higher in the simultaneous implantation of artificial sphincter( 40.0 %). The primary isolated organism was Staphylococcus epidermidis(53.8 %). The removed penile prostheses were malleable(AMS 600) in 8 patients and inflatable( Hydroflex 1, AMS 700 2, AMS 700CX 1, AMS Ultrex 1) in 5. Among the 8 cases who underwent reimplantation 2 were inserted at the time of removal( immediate), 2 one week later(early) and 4 six months later (late). The two cases of immediate reimplantation were those with 3-piece inflatable prostheses of which pump or tube was infected. The infected inflatable prostheses were removed totally and replaced with self-contained prostheses. The reimplanted prostheses were removed again due to reinfection in two cases of the early reimplantation and in one case of the late reimplantation. In conclusion, a delay of at least 6 months after removal of the infected prosthesis is thought to be the safest for reimplantation. And in case of 3-piece inflatable prosthesis of which pump and/or tube is infected, total removal of the prosthesis and immediate replacement with noninflatable or self-contained prosthesis would be a good method.