Inflatable Penile Implant Infection: Predisposing Factors and Treatment Suggestions

A retrospective review of 1,337 consecutive inflatable prosthesis implantations was done to detect predisposing factors for infection. Operations were performed by the same team during a 7-year period. Of the procedures 823 were primary implantations, while the remaining 514 were either revisions (mechanical failure, iatrogenic causes or patient dissatisfaction), salvage operations or removals for infection. The etiology of impotence as a predisposition for infection in primary implantations was significant for spinal cord injury (9% of the cases) and steroid use (50%). Diabetes had a statistically insignificant 3% risk of infection, with all other causes having a 1% infection rate. A total of 428 revisions was performed with an overall infection rate of 10%. Rates of infection ranged from 8% in nondiabetics to 18% in diabetics requiring revision. Staphylococcus species were the most commonly cultured organisms. Salvage operations (29 cases) of several types were attempted for infected prostheses. Our results with salvage were poor and we currently routinely remove the entire prosthesis for infection except in cases of urethral erosion of 1 cylinder.