Mp76-12 Comparing Bacterial Presence With the Usage of 0.05% Chlorhexidine Gluconate (Chg) Lavage During Urologic Prosthesis Revision Surgery: Update on Results

You have accessJournal of UrologySexual Function/Dysfunction: Surgical Therapy II (MP76)1 May 2024MP76-12 COMPARING BACTERIAL PRESENCE WITH THE USAGE OF 0.05% CHLORHEXIDINE GLUCONATE (CHG) LAVAGE DURING UROLOGIC PROSTHESIS REVISION SURGERY: UPDATE ON RESULTS Gerard Henry, Andrew R. Stuart, Lynn Tong, Anthony Stuart, and Edward Karpman Gerard HenryGerard Henry , Andrew R. StuartAndrew R. Stuart , Lynn TongLynn Tong , Anthony StuartAnthony Stuart , and Edward KarpmanEdward Karpman View All Author Informationhttps://doi.org/10.1097/01.JU.0001009484.98400.42.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: An Inflatable Penile Prosthesis (IPP) is third line surgical therapy for refractory ED. An IPP uses a fluid-filled reservoir with a pump and valve system to activate inflation and deflation. Although penile implants achieve the highest success rates in ED treatment, the possible presence of bacteria on the device itself or bacteria exposure accumulated during the surgery increases the risk of progression into biofilm or infection. Biofilm complicates the bacteria eradication effort and can ultimately jeopardize the implant. Often, the only way to treat the post-op infection is with implant removal. Currently, many preventative measures, such as different perioperative irrigations, are being studied to reduce the number of penile implant infections. Research has shown that irrigation at the time of both infectious and noninfectious surgery lowers subsequent infection rates. Different solutions like saline, antibiotic, betadine, and hydrogen peroxide solutions have been considered. Recently, orthopedic literature has shown that 0.05% Chlorhexidine Gluconate (CHG) lavage has effectively reduced biofilm in artificial joint procedures. The purpose of this study is to determine the effectiveness of CHG lavage on bacterial presence in IPP implant spaces. We hypothesize that CHG will lower bacterial presence after washing out implant spaces at time of replacement for infections and mechanical failure. METHODS: We aimed to investigate a series of patients who underwent revision IPP surgery while utilizing FDA-approved CHG lavage for irrigation and compared the bacterial presence before and after CHG washout. Additionally, Next Generation Sequencing (NGS), a DNA sequencing technology, was used to further identify the pathogens involved. RESULTS: Between 2021 to 2023, 48 patients underwent IPP revision surgery for either infectious or noninfectious reasons. During the operation, a section of the capsule tissue surrounding the implanted IPP pump was first taken and sent for cultures. NGS studies were also sent out. After the implant removal, all implant spaces were irrigated and washed out with CHG (two 450-mL bottles). A second tissue culture was then obtained post washout. Of the 48 patients, there were 4 positive bacterial cultures before washout and 13 positive NGS results. Results of the post CHG washout cultures were all negative. CONCLUSIONS: Irrigation with 0.05% Chlorhexidine Gluconate solution is an effective antiseptic that can decrease bacterial presence, and hopefully reduce IPP infections. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1247 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Gerard Henry More articles by this author Andrew R. Stuart More articles by this author Lynn Tong More articles by this author Anthony Stuart More articles by this author Edward Karpman More articles by this author Expand All Advertisement PDF downloadLoading ...