ABSTRACT
ABSTRACT Introduction: Aim of this study is to investigate bacterial growth on non-infected devices and compare antibiotic-coated and non-coated implants. Materials and methods: The charts of 71 patients who underwent revision surgeries for penile prosthesis between 1995 and 2013 were reviewed. Of those, 31 devices were antibiotic-coated prostheses, while 40 of the implants were non-coated. Swab cultures were routinely obtained from corporal, pump or reservoir site during the operation. If a bacterial biofilm was determined on the prosthesis, it was also cultured. Results: A total of 5 different organisms were cultured from 18 patients. Of them, 4 devices were antibiotic-coated and the other 14 were non-coated devices. Staphylococcus epidermidis was the most common organism, while Staphylococcus hominis, beta hemolitic streptococcus, Escherichia coli and Proteus mirabilis were also cultured. All patients who had positive cultures were treated with appropriate antibiotics for four weeks postoperatively. Median follow-up time was 41 months, ranging between 8 and 82 months. One prosthesis (non-coated) became clinically infected in the follow-up period with a totally different organism. Culture positivity rates of antibiotic-coated and non-coated devices were 13% and 35% respectively and the result was significant (p=0.00254). Conclusions: Positive bacterial cultures are present on non-infected penile prostheses at revision surgeries in some of the patients. Antibiotic coated prostheses have much less positive cultures than non-coated devices.
Subject(s)
Humans , Staphylococcus epidermidis/growth & development , Penile Prosthesis/microbiology , Prosthesis-Related Infections/prevention & control , Anti-Bacterial Agents/administration & dosage , Staphylococcus epidermidis/drug effects , Time Factors , Colony Count, Microbial , Microbial Sensitivity Tests , Penile Prosthesis/adverse effects , Cells, Cultured , Prospective Studies , Retrospective Studies , Prosthesis-Related Infections/etiology , Drug Delivery Systems , Middle AgedABSTRACT
Penile prostheses are subject to a continuous development and have gained better mechanical reliability and safety during the last decades. In this study, we aimed to investigate the outcomes and satisfaction rates of inflatable penile prosthesis (IPP) and semirigid penile prosthesis (SPP) implantation.
From August 2001 to June 2012, 257 men with erectile dysfunction (ED) underwent penile prosthesis implantation (PPI) at our institution. Of the 257 patients, 118 underwent implantation of IPP and 139 underwent SPP implantation. The pre-operative and post-operative erectile status of the patients were assessed by international index of erectile function (IIEF) questionnaire. The satisfaction of patients and partners were evaluated by a telephone interview using the erectile dysfunction inventory of treatment satisfaction (EDITS) questionnaire and EDITS partner survey.
The overall major complication rate was higher in IPP group. PPI led to a significant improvement in IIEF scores in both groups. For IPP and SPP groups the average EDITS scores were 78±11and 57±8, respectively, and that for the partners were 72±10 and 49±7, respectively (p<0.05).
Although the IPP implantation have better satisfaction rates, the SPP implantation is still a viable treatment option in the surgical treatment of ED because of low cost and high durability with acceptable satisfaction rates.
Subject(s)
Adult , Aged , Humans , Male , Middle Aged , Erectile Dysfunction/surgery , Penile Prosthesis , Patient Satisfaction/statistics & numerical data , Penile Implantation/methods , Erectile Dysfunction/physiopathology , Postoperative Complications , Prosthesis Design , Penile Prosthesis/adverse effects , Retrospective Studies , Sexual Partners , Statistics, Nonparametric , Surveys and Questionnaires , Treatment OutcomeABSTRACT
A disfunção erétil do pênis é uma condição de alta prevalência na população mascuina a partir dos 50 anos de idade, principalmente em pacientes portadores de arteriosclerose, diabetes e naqueles submetidos a cirurgias pélvicas, como prostatectomia radical ou amputação abdominoperineal. Várias formas de tratamento clínico e cirúrgico estão disponíveis para este tipo de paciente. A utilização de próteses penianas é uma alternativa segura e eficaz no tratamento de pacientes com disfunção erétil. Neste artigo é realizada uma revisão dos principais tipos de prótese, as indicações para a sua utilização, dos cuidados pré, per ou pós-operatórios em pacientes que se submeterão a este tipo de cirurgia, bem como dos seus resultados e complicações.
Subject(s)
Humans , Male , Penile Implantation , Penile Prosthesis/classification , Penile Prosthesis , Penile Prosthesis/adverse effects , Erectile Dysfunction/surgery , Intraoperative CareABSTRACT
To date, there are 10,000,000 men with impotence in the United States and it is estimated that at least 17,000 penile prosthesis are implanted annually. The most fearsome complication is the infection of the prosthesis which is usually caused by Staphylococcus epidermidis (in 40-80 of the cases). In general, the incidence of infection is actually 0.8-8.3, but it can increase to 37 in patients with tertiary implants. The initial empiric treatment is usually with vancomycin and aminoglycosides and prophylaxis is recommended with a penicillinase-resistant synthetic penicillins, first generation cephalosporins, or vancomycin in case of penicillin allergy
Subject(s)
Humans , Male , Staphylococcal Infections/etiology , Prosthesis-Related Infections , Penile Prosthesis/adverse effects , Anti-Bacterial Agents/therapeutic use , Bacteria/isolation & purification , Fungi/isolation & purification , Gonorrhea/etiology , Gonorrhea/prevention & control , Gonorrhea/therapy , Staphylococcal Infections/prevention & control , Staphylococcal Infections/therapy , Prosthesis-Related Infections/microbiology , Prosthesis-Related Infections/prevention & control , Mycoses , Neisseria gonorrhoeae/isolation & purification , Premedication , Staphylococcus epidermidis/isolation & purificationABSTRACT
Currently there are more than 10 types of penile prosthesis available, ranging from the very simple to the very sophisticated. We review our experiences with various penile prosthesis, with particular regard to the complication rate. From Dec. 1983 to Jul. 1993, we implanted 295 penile prosthesis of eight different types. The average age of patients was 44 years. Every patient was evaluated with various multidisplinary diagnostic approaches. The etiologies of impotence were vasculogenic 29%, diabetogenic 22%, spinal cord injury 16%, pelvic bone injury 11%, etc. The types of implanted prosthesis were AMS malleable 143, Jonas 42, Dynaflex 36, Hydroflex 8, Uni-Flate 1000 2, AMS 700 CXM 58, Ultrex 3, Mentor alpha-1 3 and the mean follow-up period was 34 months. The diameters of implanted prosthesis were from 9.5 mm to 13 mm, mostly 9.5 mm (52.9%). The length of implanted prosthesis were from 10 cm to 20 cm, mostly 16 approximately 18 cm (68.8%). Cases with uneven diameters or lengths were 20 (6.8%). The int aoperative complications were 1 corporeal rupture and 1 bladder rupture, and the postoperative complications were 2 prosthesis infections, 2 mechanical failures, and 1 prosthesis infection with mechanical failure. In those 4 patients reimplantations were successful. More than 99% (290/291) patients still have functioning prosthesis. Every prosthesis has their advantages and disadvantages. Factors to be analysed in the selection of proper prosthesis should include patients economic status, education, personality, social activity, hand dexterity, and penile size.
Subject(s)
Adult , Aged , Humans , Male , Evaluation Study , Korea , Middle Aged , Penile Prosthesis/adverse effects , Reproducibility of ResultsABSTRACT
Apesar de toda a evolucao ocorrida nos ultimos anos para o tratamento da disfuncao eretil masculina, como a introducao de novas drogas vaso ativas, dispositivos a vacuo, o implante de protese peniana continua a representar uma forma de tratamento bastante utilizada e com elevados indices de aceitacao por parte dos pacientes. Mesmo que os indices de complicacoes operatorias tenham diminuidos, particularmente porque a cirurgia pode ser feita de ambulatorio, a infeccao do espaco peri-protetico representa um risco em torno de 2 por cento a 7 por cento dos implantes. Geralmente, os urologistas preferem esperar alguns meses para tentar novo implante de protese. Porem, as dificuldades tecnicas aumentam bastante dado o grau de fibrose. Apresentamos um caso de reimplante de protese peniana em um paciente que apresentou infeccao e que resultou em fibrose intensa dos corpos cavernosos, apontando aspectos relacionados a tecnica operatoria e ao seguimento destes pacientes.
Subject(s)
Humans , Male , Adult , Erectile Dysfunction/surgery , Penile Prosthesis/adverse effects , Infections/etiology , Replantation/statistics & numerical dataABSTRACT
Das possiveis complicacoes associadas ao implante de proteses penianas, a infeccao e a mais desastrosa. O tratamento usual e a remocao cirurgica deixando a corporite cicatrizar, para entao reimplantar a nova protese. Apresentamos tres pacientes com infeccao de protese peniana, tratados pela retirada da protese, irrigacao copiosa dos corpos cavernosos com solucao antibiotica e recolocacao de nova protese em curto espaco de tempo. Este procedimento tem sido denominado de "Resgate da Protese Peniana" e parece representar uma alternativa as dificuldades de reimplante pela conduta tradicional...
Subject(s)
Humans , Male , Middle Aged , Staphylococcal Infections/etiology , Penile Prosthesis/adverse effects , Staphylococcus epidermidis , Staphylococcal Infections/therapyABSTRACT
Os autores fazem uma revisao sobre o tratamento cirurgico e nao cirurgico da disfuncao sexual masculinna organica. Enfatizam que melhores resultados podem ser obtidos se um diagnostico exato for feito. Medidas terapeuticas devem ser oferecidas ao paciente de acordo com a extensao de sua doenca e idade, comecando por procedimentos menos agressivos
Subject(s)
Humans , Male , Trazodone/therapeutic use , Yohimbine/therapeutic use , Nitroglycerin/therapeutic use , Erectile Dysfunction/surgery , Erectile Dysfunction/drug therapy , Erectile Dysfunction/therapy , Intraoperative Period , Penile Prosthesis/adverse effects , VacuumABSTRACT
Se presentan 600 casos de Disfunción Erectiva. Se revisa la frecuencia de los diferentes grupos etiológicos, y se analizan aspectos estadísticos de interés. 66 de estos 600 casos fueron tratados con prótesis peneanas, lo cual representa el 11 por ciento de las formas de tratamiento. Se revisan aspectos de interés sobre prótesis peneanas: indicaciones, complicaciones, resultados y otros aspectos importantes