Staff Members - Benha University
CONSERVATIVE THERAPY IS A FEASIBLE AND EFFECTIVE OPTION IN PATIENTS WITH LOCALIZED INFECTION AFTER PENILE IMPLANT SURGERY
J UROLOGY • 2019
Publication Information
Authors
Mohamad Habous
,
Osama Laban
,
Osama Abdelwahab
,
Richard Santucci
,
Saad Mahmoud
, and
John Mulhall
Keywords
Not Available
Journal
J UROLOGY
Publisher
Not Available
Volume
Not Available
Issue
Not Available
Pages
Not Available
publication.type
International
Paper Link
Open Link
Supplementary Materials
Not Available
Abstract
INTRODUCTION AND OBJECTIVES
Traditionally penile implant (PI) infections have been managed by removal with immediate or delayed replacement. Recently, conservative therapy (CT) using antibiotic therapy has received increased interest. We aimed to investigate the success rate and predictive factors affecting the outcome of CT in PI infection patients.
METHODS
Patients diagnosed with early, localized PI infection were considered candidates for CT. Exclusion criteria included fever > 37.5 Celsius, scrotal pump fixation to skin, WBC >13,000 and appearance of any sign of toxeamia like malaise or rigors. In patients with purulent drainage, culture swabs were taken and the antibiotic was chosen based on sensitivity results. Oral antibiotics were used until the local infection was completely resolved. Patient were evaluated weekly during this process
RESULTS
37 patients constituted the study population. Mean age = 58±1.5 (37-85) years. All were diabetic. Mean BMI =31±0.8 (24-47). PI was malleable in 33 and inflatable in 4 cases. Culture results (n=19) included: Staph epidermidis (8), Pseudomonas (4), E coli (4), Staph aureus (3). Mean time to complete healing was 48±2.3 (29-97) days. 4/37 needed the PI removed due to failure to respond and onset of systemic symptoms at a mean time-point of 75±1.8 days after CT commencement. 2/37 has PI removal because of persistent penile pain despite complete wound healing, at a mean time point of 128±2.5 days after CT commencement. The remaining 31 has complete infection resolution and resumed their normal sexual activity.
CONCLUSIONS
CT of localized PI infection appears to be a viable option for such patients with the majority of patients retaining their implant and resuming satisfactory sexual activity
Traditionally penile implant (PI) infections have been managed by removal with immediate or delayed replacement. Recently, conservative therapy (CT) using antibiotic therapy has received increased interest. We aimed to investigate the success rate and predictive factors affecting the outcome of CT in PI infection patients.
METHODS
Patients diagnosed with early, localized PI infection were considered candidates for CT. Exclusion criteria included fever > 37.5 Celsius, scrotal pump fixation to skin, WBC >13,000 and appearance of any sign of toxeamia like malaise or rigors. In patients with purulent drainage, culture swabs were taken and the antibiotic was chosen based on sensitivity results. Oral antibiotics were used until the local infection was completely resolved. Patient were evaluated weekly during this process
RESULTS
37 patients constituted the study population. Mean age = 58±1.5 (37-85) years. All were diabetic. Mean BMI =31±0.8 (24-47). PI was malleable in 33 and inflatable in 4 cases. Culture results (n=19) included: Staph epidermidis (8), Pseudomonas (4), E coli (4), Staph aureus (3). Mean time to complete healing was 48±2.3 (29-97) days. 4/37 needed the PI removed due to failure to respond and onset of systemic symptoms at a mean time-point of 75±1.8 days after CT commencement. 2/37 has PI removal because of persistent penile pain despite complete wound healing, at a mean time point of 128±2.5 days after CT commencement. The remaining 31 has complete infection resolution and resumed their normal sexual activity.
CONCLUSIONS
CT of localized PI infection appears to be a viable option for such patients with the majority of patients retaining their implant and resuming satisfactory sexual activity