IMMEDIATE SALVAGE PROCEDURE FOR INFECTED PENILE PROSTHESIS

Purpose: The most devastating complication after the insertion of a pe nile prosthesis is the development of infection. The standard approach involves removing the entire device, treating intensively with antibi otics and attempting to reinsert a prosthesis at a later date, often w ith a suboptimal result. Based on the encouraging results of others, d uring the last 24 months we have used in 2 separate private urological practices a salvage procedure for treatment of infected inflatable pe nile prostheses. Materials and Methods: The protocol used in 7 men wit h an infected inflatable penile prosthesis included removal of all dev ice components, a 7-step vigorous intraoperative irrigation with 4 dif ferent solutions, including vancomycin, immediate reimplantation of a new inflatable penile prosthesis and postoperative outpatient antibiot ics with oral ciprofloxacin or intravenous vancomycin or cefazolin. Re sults: Of the 7 men 6 have experienced excellent results with no infec tion, minimal morbidity and preservation of penile length. The only fa ilure occurred in a poorly controlled diabetic who required multiple r evisions and may have had latent infection for months before it became apparent. Conclusions: We believe that an immediate salvage procedure for an infected inflatable penile prosthesis is an effective treatmen t for this difficult complication.