Risk Factors for Penile Prosthetic Infection

PURPOSE: We determined the risk factors for penile prosthesis infections. MATERIALS AND METHODS: The records of 156 men undergoing 167 procedures for insertion of a penile prosthesis were reviewed. The device was implanted during a primary uncomplicated procedure in 114 cases. Simultaneous penile reconstruction was performed in 23 cases. A malfunctioning penile prosthesis was replaced or repaired immediately following removal in 30 cases. Minimum followup was 1 year. RESULTS: The infection rate was 1.8% after insertion of a penile prosthesis in 114 men without previous penile surgery compared to 21.7% for procedures requiring reconstruction of the corpora, which was significantly different (p < 0.01). The infection rate after revision of a penile prosthesis was 13.3%, which was significantly greater than that following primary uncomplicated implantation (p < 0.05) but not different from that for patients requiring reconstruction (p = 0.5). There was no difference in patient age, etiology of impotence or associated medical disorders among the 3 groups. Operative time was significantly longer for patients requiring penile reconstruction than for the other 2 groups (p < 0.01). CONCLUSIONS: The risk of infection is significantly greater when penile reconstruction is required, and appears to be related to increased duration of surgery. The increased risk of infection associated with revision of a penile prosthesis cannot be explained by patient characteristics or operative time.