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Published in: Current Sexual Health Reports 3/2019

01-09-2019 | Antibiotic | Male and Female Surgical Interventions (C Carson and M Khera, Section Editors)

Penile Prosthesis Salvage: Review of Past and Current Practices

Authors: Ryan Barlotta, Christopher Foote, Jay Simhan

Published in: Current Sexual Health Reports | Issue 3/2019

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Abstract

Purpose of Review

This review highlights landmark studies and recent literature regarding penile implant salvage in the setting of infection. We discuss both the historically relevant treatments and newest trends in current practice.

Recent Findings

The most recent studies indicate that most penile prosthesis infections can be managed with explantation and washout with immediate implantation of malleable prosthesis. This technique allows for prevention of corporal fibrosis and possible transition to future inflatable penile prosthesis.

Summary

While prosthetic infection rates have declined over the years, a 1–3% risk still remains. Originally, prosthetic infections were treated by immediate explantation with consideration for re-implantation months later once the acute period for infection had been managed with broad spectrum antibiotics. However, a landmark study by Mulcahy in 1996 advocated for explantation, antibiotic-based washout, and immediate re-implantation. More recent studies have favored a malleable implant salvage technique (MIST) to preserve penile length. This technique includes explantation, washout, and immediate malleable prosthesis insertion. Further, some researchers are now examining use of temporary intracorporal antibiotic-infused calcium sulfate paste in the setting of implant salvage.
Literature
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go back to reference •• Gross MS, Phillips EA, Balen A, Eid JF, Yang C, Simon R, et al. The malleable implant salvage technique: infection outcomes after mulcahy salvage procedure and replacement of infected inflatable penile prosthesis with malleable prosthesis. J Urol. 2016;195:694–7. https://doi.org/10.1016/j.juro.2015.08.091 Describes technique often accepted as best current practice for most implant salvage cases. CrossRefPubMed •• Gross MS, Phillips EA, Balen A, Eid JF, Yang C, Simon R, et al. The malleable implant salvage technique: infection outcomes after mulcahy salvage procedure and replacement of infected inflatable penile prosthesis with malleable prosthesis. J Urol. 2016;195:694–7. https://​doi.​org/​10.​1016/​j.​juro.​2015.​08.​091 Describes technique often accepted as best current practice for most implant salvage cases. CrossRefPubMed
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Metadata
Title
Penile Prosthesis Salvage: Review of Past and Current Practices
Authors
Ryan Barlotta
Christopher Foote
Jay Simhan
Publication date
01-09-2019
Publisher
Springer US
Published in
Current Sexual Health Reports / Issue 3/2019
Print ISSN: 1548-3584
Electronic ISSN: 1548-3592
DOI
https://doi.org/10.1007/s11930-019-00209-8

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