Infected penile prosthesis: literature review highlighting the status quo of prevention and management

Aging Male. 2020 Dec;23(5):447-456. doi: 10.1080/13685538.2018.1519786. Epub 2018 Oct 15.

Abstract

Introduction: Erectile dysfunction affects over 50% of men 70 years and above, and penile prosthesis (PP) is its third-line treatment. Complications of PPs include infection, however, no formal guidelines exist for its management.

Methods: We performed a literature search and reviewed 53 recent published literatures of experiences with management of PP infections, prevention, and treatment.

Results: Acute infection can present early with pain and discharge and detection of early signs is of utmost importance. MRI studies are more sensitive than CT studies to diagnose and plan surgical intervention. Introduction of antibiotic impregnated devices attributed to the reduction of infection rates with superiority proven for certain types; the no-touch technique had further reduced this rate. The Mulcahy salvage remains the most widely used surgical approach for treatment despite modifications and novel techniques described; conservative management of PP infections is recently reported with promising results.

Conclusions: Despite absence of strict guidelines for the management of infected PPs, we reviewed and discussed numerous panel opinions and suggestions throughout literature. More research into the pathology, prevention, conservative management and advances in surgical treatment of this condition are called for to produce guidelines that unite the efforts to tackle these infections.

Keywords: Penile prosthesis; erectile dysfunction; infections; prosthesis.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Erectile Dysfunction* / drug therapy
  • Humans
  • Male
  • Penile Prosthesis*

Substances

  • Anti-Bacterial Agents