REDUCING THE LOSS OF IMPLANTS FOLLOWING PENILE PROSTHETIC SURGERY

Objective To assess the factors associated with loss of implant follow ing penile prosthetic surgery and to make alterations in the managemen t of patients to prevent this from occurring. Patients and methods A r etrospective analysis was carried out of the factors associated with p ost-operative infection and erosion in 188 patients who underwent impl antation of penile prostheses. A prospective study was then establishe d in which 62 patients were managed by a set protocol designed to coun teract the factors identified as being contributory to loss of implant s in the retrospective review. Results In the retrospective study nine (4.8%) patients lost a prosthesis due to erosion. Erosion was noted t o be more common with one type of implant which has since been modifie d. Infection was the cause of prosthesis loss in 12.2% of patients in the retrospective review. The new protocol resulted in a significantly reduced infection rate in penile prostheses to 1.6% (P < 0.05). Concl usion With attention to simple antiseptic prophylaxis, antibiotic pene tration and continuing audit, a significant improvement in the loss of penile prostheses can be achieved along with a reduction in the amoun t of antibiotics prescribed.