Infection reduction using antibiotic-coated inflatable penile prosthesis.

Author(s): Wilson SK, Zumbe J, Henry GD, Salem EA, Delk JR, Cleves MA

Affiliation(s): University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205, USA.

Publication date & source: 2007-08, Urology., 70(2):337-40.

Publication type: Randomized Controlled Trial; Research Support, Non-U.S. Gov't

OBJECTIVES: Inflatable penile prosthesis (IPP) infection remains a devastating surgical complication. American Medical Systems recently introduced an IPP with a coating of minocycline HCL and rifampin (InhibiZone). We report our experience with this coating and compare the rate of infection with our historical rate. METHODS: A total of 467 patients receiving InhibiZone-coated IPPs were followed up for infection. The patients were stratified into four groups: nondiabetic, first-time (virgin) implants; diabetic, virgin implants; revision without washout; and revision with antiseptic solution washout. All patients were observed for longer than 1 year. The infection rates were compared with our published data of noncoated IPPs. RESULTS: No infections developed among the 223 virgin implants in nondiabetic patients. Of the 83 diabetic patients with virgin implants, 1 developed an infection (1%). Of the 39 revision patients without washout, 4 (10%) had infections. When an antiseptic washout was used in patients requiring revision, the infection rate dropped to 3% (4 of 123). Compared with our previous publications of infection rates with noncoated implants, InhibiZone-coated IPPs showed a statistically significant reduction in infection in virgin nondiabetic, virgin diabetic, and revision with washout implants. No reduction in the infection rate occurred among revision patients without washout. CONCLUSIONS: Antibiotic-coated implants become infected less often in virgin, nondiabetic and virgin, diabetic patients than in our historical experience with noncoated implants. However, antibiotic-coated implants used in revision surgery did not reduce the infection rate unless adjunctive antiseptic solution washout was also used.