Penil Protez Enfeksiyonları: Son 30 Yılda Neler Değişti

Öz

Erektil disfonksiyon erkek nüfusunda sık karşılaşılan bir sağlık sorunudur. Son yıllarda medikal tedavisinde önemli gelişmeler olmasına rağmen, bu tedavi yöntemlerinin her hastaya uygun olmadığı bilinmektedir. Penil protezler, medikal tedavilere göre daha invaziv bir seçenek olsalar da erektil disfonksiyon tedavisinde kesin bir çözüm sunmaktadır. Ancak penil protez operasyonlarından sonra görülen enfeksiyonlar bu cerrahi girişimin en korkulan yanıdır. Bu enfeksiyonlar sepsis ve penil doku nekrozu ile sonlanabilmektedir. Bu durum hem hasta hem de hekim açısından istenilmeyen bir sonuçtur; bu nedenle, bu tür operasyonlardan önce enfeksiyonu önlemek için diğer cerrahi girişimlerden daha titiz bir yaklaşım gerekmektedir. Bu derleme yazının amacı, son 30 yılda penil protez enfeksiyonlarını önleme ve tedavi yöntemlerinde hangi yeniliklerin uygulandığını incelemektir.

Anahtar Kelimeler

• penil protez
• enfeksiyon
• erektil disfonksiyon

Infections of Penile Prostheses: What Changed During The Last 30 Years

Öz

Erectile dysfunction is a common health issue among men. Despite significant advancements in medical treatment in recent years, it is known that these treatment methods may not be suitable for every patient. Penile prostheses, while being a more invasive option compared to medical treatments, provide a definitive solution for the treatment of erectile dysfunction. However, infections that occur after penile prosthesis surgeries are among the most feared complications of this surgical intervention. These infections can lead to severe complications, such as sepsis and penile necrosis. This situation is undesirable for the patient and the physician; therefore, a more meticulous approach is required to prevent infections before these types of surgeries compared to other surgical interventions. This review article aims to examine the innovations implemented in preventing and treating penile prosthesis infections over the past 30 years.

Anahtar Kelimeler

• penil prosthesis
• infections
• erectil dysfunction

Kaynakça

1. 1. Goldstein I, Goren A, Li VW, Tang WY, Hassan TA. Epidemiology Update of Erectile Dysfunction in Eight Countries with High Burden. Sex Med Rev. 2020 Jan;8(1):48-58.
2. 2. Scott FB, Bradley WE, Timm GW. Management of erectile impotence. Use of implantable inflatable prosthesis. Urology. 1973 Jul;2(1):80-2.
3. 3. Pearman RO. Treatment of organic impotence by implantation of a penile prosthesis. J Urol. 1967 Apr;97(4):716-9.
4. 4. Small MP, Carrion HM, Gordon JA. Small-Carrion penile prosthesis. New implant for management of impotence. Urology. 1975 Apr;5(4):479-86.
5. 5. Gon LM, de Campos CCC, Voris BRI, Passeri LA, Fregonesi A, Riccetto CLZ. A systematic review of penile prosthesis infection and meta-analysis of diabetes mellitus role. BMC Urol. 2021 Mar 10;21(1):35.
6. 6. Jarow JP. Risk factors for penile prosthetic infection. J Urol. 1996 Aug;156(2 Pt 1):402-4.
7. 7. Mahon J, Dornbier R, Wegrzyn G, Faraday MM, Sadeghi-Nejad H, Hakim L, McVary KT. Infectious Adverse Events Following the Placement of a Penile Prosthesis: A Systematic Review. Sex Med Rev. 2020 Apr;8(2):348-354.
8. 8. Carson CC 3rd, Mulcahy JJ, Harsch MR. Long-term infection outcomes after original antibiotic impregnated inflatable penile prosthesis implants: up to 7.7 years of follow up. J Urol. 2011 Feb;185(2):614-8.

9. 9. Mulcahy JJ. Penile prosthesis infection: progress in prevention and treatment. Curr Urol Rep. 2010 Nov;11(6):400-4. doi: 10.1007/s11934-010-0140-6.
10. 10. Trost LW, McCaslin R, Linder B, Hellstrom WJ. Long-term outcomes of penile prostheses for the treatment of erectile dysfunction. Expert Rev Med Devices. 2013 May;10(3):353-66.
11. 11. Baird BA, Parikh K, Broderick G. Penile implant infection factors: a contemporary narrative review of literature. Transl Androl Urol. 2021 Oct;10(10):3873-3884.
12. 12. Burnett AL, Nehra A, Breau RH, Culkin DJ, Faraday MM, Hakim LS, Heidelbaugh J, Khera M, McVary KT, Miner MM, Nelson CJ, Sadeghi-Nejad H, Seftel AD, Shindel AW. Erectile Dysfunction: AUA Guideline. J Urol. 2018 Sep;200(3):633-641.
13. 13. Fishman IJ, Scott FB, Selim AM. Rescue Procedure: An Alternative to Complete Removal for Treatment of Infected Penile Prosthesis. Journal of Urology. 1987 Jun 1;137(6):202A.
14. 14. Mandava SH, Serefoglu EC, Freier MT, Wilson SK, Hellstrom WJ. Infection retardant coated inflatable penile prostheses decrease the incidence of infection: a systematic review and meta-analysis. J Urol. 2012 Nov;188(5):1855-60.
15. 15. Licht MR, Montague DK, Angermeier KW, Lakin MM. Cultures from genitourinary prostheses at reoperation: questioning the role of Staphylococcus epidermidis in periprosthetic infection. J Urol. 1995 Aug;154(2 Pt 1):387-90.
16. 16. Carson CC. Diagnosis, treatment and prevention of penile prosthesis infection. Int J Impot Res. 2003 Oct;15 Suppl 5:S139-46.
17. 17. Henry GD, Wilson SK, Delk JR 2nd, Carson CC, Silverstein A, Cleves MA, Donatucci CF. Penile prosthesis cultures during revision surgery: a multicenter study. J Urol. 2004 Jul;172(1):153-6.
18. 18. Henry GD, Carson CC, Wilson SK, Wiygul J, Tornehl C, Cleves MA, Simmons CJ, Donatucci CF. Revision washout decreases implant capsule tissue culture positivity: a multicenter study. J Urol. 2008 Jan;179(1):186-90; discussion 190.
19. 19. Jefferson KK. What drives bacteria to produce a biofilm? FEMS Microbiol Lett. 2004 Jul 15;236(2):163-73.
20. 20. Welliver RC Jr, Hanerhoff BL, Henry GD, Köhler TS. Significance of biofilm for the prosthetic surgeon. Curr Urol Rep. 2014 Jun;15(6):411.
21. 21. Costerton W, Veeh R, Shirtliff M, Pasmore M, Post C, Ehrlich G. The application of biofilm science to the study and control of chronic bacterial infections. J Clin Invest. 2003 Nov;112(10):1466-77.
22. 22. Hofer MD, Gonzalez CM. Current Concepts in Infections Associated with Penile Prostheses and Artificial Sphincters. Urol Clin North Am. 2015 Nov;42(4):485-92.
23. 23. Stewart PS, Costerton JW. Antibiotic resistance of bacteria in biofilms. Lancet. 2001 Jul 14;358(9276):135-8.
24. 24. Wilson SK, Carson CC, Cleves MA, Delk JR 2nd. Quantifying risk of penile prosthesis infection with elevated glycosylated hemoglobin. J Urol. 1998 May;159(5):1537-9; discussion 1539-40.
25. 25. Canguven O, Talib R, El Ansari W, Khalafalla K, Al Ansari A. Is Hba1c level of diabetic patients associated with penile prosthesis implantation infections? Aging Male. 2018 Mar 9:1-6.
26. 26. Carvajal A, Benavides J, García-Perdomo HA, Henry GD. Risk factors associated with penile prosthesis infection: systematic review and meta-analysis. Int J Impot Res. 2020 Nov;32(6):587-597.
27. 27. Habous M, Tal R, Tealab A, Soliman T, Nassar M, Mekawi Z, et al. Defining a glycated haemoglobin (HbA1c) level that predicts increased risk of penile implant infection. BJU Int. 2018 Feb;121(2):293-300.
28. 28. Lipsky MJ, Onyeji I, Golan R, Munarriz R, Kashanian JA, Stember DS, et al. Diabetes Is a Risk Factor for Inflatable Penile Prosthesis Infection: Analysis of a Large Statewide Database. Sex Med. 2019 Mar;7(1):35-40.
29. 29. Mulcahy JJ, Carson CC 3rd. Long-term infection rates in diabetic patients implanted with antibiotic-impregnated versus nonimpregnated inflatable penile prostheses: 7-year outcomes. Eur Urol. 2011 Jul;60(1):167-72.
30. 30. Gross MS 2, Reinstatler L, Henry GD, Honig SC, Stahl PJ, Burnett AL, et al. Multicenter in vestigation of fungal infections of inflatable penile prostheses. J Sex Med. 2019 Jul; 16(7):1100–5.
31. 31. Li K, Brandes ER, Chang SL, Leow JJ, Chung BI, et al. Trends in penile prosthesis implantation and analysis of predictive factors for removal. World J Urol 2019; 37: 639–46.
32. 32. Wilson SK, Delk JR 2nd. Inflatable penile implant infection: predisposing factors and treatment suggestions. J Urol 1995; 153: 659–61.
33. 33. Cuellar DC, Sklar GN. Penile prosthesis in the organ transplant recipient. Urology. 2001 Jan;57(1):138-41.
34. 34. Carrasquillo RJ, Munarriz RM, Gross MS. Infection Prevention Considerations for Complex Penile Prosthesis Recipients. Curr Urol Rep. 2019 Feb 1;20(3):12.
35. 35. Tienforti D, Totaro M, Spagnolo L, Di Giulio F, Castellini C, Felzani G, et al. Infection rate of penile prosthesis implants in men with spinal cord injury: a meta-analysis of available evidence. Int J Impot Res. 2024 May;36(3):206-213.
36. 36. Wilson SK, Zumbe J, Henry GD, Salem EA, Delk JR, Cleves MA. Infection reduction using antibiotic-coated inflatable penile prosthesis. Urology. 2007 Aug;70(2):337-40.
37. 37. Thomalla JV, Thompson ST, Rowland RG, Mulcahy JJ. Infectious complications of penile prosthetic implants. J Urol. 1987 Jul;138(1):65-7.
38. 38. 3Eid JF, Wilson SK, Cleves M, Salem EA. Coated implants and "no touch" surgical technique decreases risk of infection in inflatable penile prosthesis implantation to 0.46%. Urology. 2012 Jun;79(6):1310-5.
39. 39. Menshchikov K, Menshchikov M, Yurasov D, Artamonov A. Risk factors for penile prosthesis infection: An umbrella review and meta-analysis. Arab J Urol. 2023 Jul 29;22(2):96-101.
40. 40. Montgomery BD, Lomas DJ, Ziegelmann MJ, Trost LW. Infection risk of undergoing multiple penile prostheses: an analysis of referred patient surgical histories. Int J Impot Res. 2018 Aug;30(4):147-152.
41. 41. Hebert KJ, Kohler TS. Penile Prosthesis Infection: Myths and Realities. World J Mens Health. 2019 Sep;37(3):276-287
42. 42. Gross MS, Phillips EA, Carrasquillo RJ, Thornton A, Greenfield JM, et al. Multicenter investigation of the micro-organisms involved in penile prosthesis infection: an analysis of the efficacy of the AUA and EAU guidelines for penile prosthesis prophylaxis. J Sex Med 2017; 14: 455–63.
43. 43. Silverstein AD, Henry GD, Evans B, Pasmore M, Simmons CJ, Donatucci CF. Biofilm formation on clinically noninfected penile prostheses. J Urol. 2006 Sep;176(3):1008-11.
44. 44. Henry G, Price G, Pryor M, et al. Observation of local clinical penile prostheses infections instead of immediate salvage rescue/removal: multicenter study with surprising result. J Urol 2014;191:e612–e613.
45. 45. Zacharakis E, Garaffa G, Raheem AA, Christopher AN, Muneer A, Ralph DJ. Penile prosthesis insertion in patients with refractory ischemic priapism: early vs delayed implantation. BJU Int. 2014 Oct;114(4):576-81.
46. 46. Ralph DJ, Garaffa G, Muneer A, Freeman A, Rees R, Christopher AN, et al. The immediate insertion of a penile prosthesis for acute ischemic priapism. Eur Urol. 2009 Dec;56(6):1033-8.
47. 47. Burnett AL, Sharlip ID. Standard operating procedures for priapism. J Sex Med. 2013 Jan;10(1):180-94.
48. 48. EAU Guidelines. Edn. presented at the EAU Annual Congress Milan 2023. ISBN 978-94-92671-19-6.
49. 49. Johnson M, Hallerstrom M, Chiriaco G, et al. PD44-01 A com parison between early and delayed penile prosthesis insertion in men with refractory ischemic priapism. J Urol 2019; 201(Supplement 4).
50. 50. Mulhall JP, Schiff J, Guhring P. An analysis of the natural history of Peyronie's disease. J Urol. 2006 Jun;175(6):2115-8; discussion 2118.
51. 51. Verze P, Sokolakis I, Manfredi C, Collà Ruvolo C, Hatzichristodoulou G, Romero-Otero J. Penile prosthesis implant in the management of Peyronie’s' disease. Minerva Urol Nephrol. 2021 Apr;73(2):196-214.
52. 52. DiBlasio CJ, Kurta JM, Botta S, Malcolm JB, Wan JY, Derweesh IH, et al. Peyronie's disease compromises the durability and component-malfunction rates in patients implanted with an inflatable penile prosthesis. BJU Int. 2010 Sep;106(5):691-4.
53. 53. Carson CC, Levine LA. Outcomes of surgical treatment of Peyronie's disease. BJU Int. 2014 May;113(5):704-13.
54. 54. Wilson SK, Cleves MA, Delk JR 2nd. Long-term follow-up of treatment for Peyronie's disease: modeling the penis over an inflatable penile prosthesis. J Urol. 2001 Mar;165(3):825-9.
55. 55. Segal RL, Cabrini MR, Bivalacqua TJ, Burnett AL. Penile straightening maneuvers employed during penile prosthesis surgery: technical options and outcomes. Int J Impot Res. 2014 Sep-Oct;26(5):182-5.
56. 56. Bokarica P, Parazajder J, Mazuran B, Gilja I. Surgical treatment of Peyronie's disease based on penile length and degree of curvature. Int J Impot Res. 2005 Mar-Apr;17(2):170-4.
57. 57. Sørensen LT. Wound healing and infection in surgery. The clinical impact of smoking and smoking cessation: a systematic review and meta-analysis. Arch Surg. 2012 Apr;147(4):373-83.
58. 58. Wilson SK, Mora-Estaves C, Egydio P, Ralph D, Habous M, Love C, Shamsodini A, Valenzuela R, Yafi FA. Glans Necrosis Following Penile Prosthesis Implantation: Prevention and Treatment Suggestions. Urology. 2017 Sep;107:144-148.
59. 59. Cakan M, Demirel F, Karabacak O, Yalçinkaya F, Altuğ U. Risk factors for penile prosthetic infection. Int Urol Nephrol. 2003;35(2):209-13.
60. 60. Kavoussi NL, Siegel JA, Viers BR, Pagliara TJ, Hofer MD, Cordon BH, et al. Preoperative Urine Culture Results Correlate Poorly With Bacteriology of Urologic Prosthetic Device Infections. J Sex Med. 2017 Jan;14(1):163-168.
61. 61. Bode LG, Kluytmans JA, Wertheim HF, Bogaers D, Vandenbroucke-Grauls CM, Roosendaal R, et al. Preventing surgical-site infections in nasal carriers of Staphylococcus aureus. N Engl J Med. 2010 Jan 7;362(1):9-17.
62. 62. Darouiche RO, Bella AJ, Boone TB, Brock G, Broderick GA, Burnett AL, et al. North American consensus document on infection of penile prostheses. Urology. 2013 Oct;82(4):937-42.
63. 63. Barham DW, Pyrgidis N, Gross MS, Hammad M, Swerdloff D, Miller J, et al. AUA-recommended Antibiotic Prophylaxis for Primary Penile Implantation Results in a Higher, Not Lower, Risk for Postoperative Infection: A Multicenter Analysis. J Urol. 2023 Feb;209(2):399-409.
64. 64. Rezaee ME, Towe M, Osman MM, Huynh LM, El-Khatib FM, Andrianne R, et al. A Multicenter Investigation Examining American Urological Association Recommended Antibiotic Prophylaxis vs Nonstandard Prophylaxis in Preventing Device Infections in Penile Prosthesis Surgery in Diabetic Patients. J Urol. 2020 Nov;204(5):969-975.
65. 65. Webster J, Osborne S. Preoperative bathing or showering with skin antiseptics to prevent surgical site infection. Cochrane Database Syst Rev. 2015 Feb 20;2015(2):CD004985.
66. 66. Chlebicki MP, Safdar N, O'Horo JC, Maki DG. Preoperative chlorhexidine shower or bath for prevention of surgical site infection: a meta-analysis. Am J Infect Control. 2013 Feb;41(2):167-73.
67. 67. Magera JS Jr, Inman BA, Elliott DS. Does preoperative topical antimicrobial scrub reduce positive surgical site culture rates in men undergoing artificial urinary sphincter placement? J Urol. 2007 Oct;178(4 Pt 1):1328-32; discussion 1332.
68. 68. Darouiche RO, Wall MJ Jr, Itani KM, Otterson MF, Webb AL, Carrick MM, et al. Chlorhexidine-Alcohol versus Povidone-Iodine for Surgical-Site Antisepsis. N Engl J Med. 2010 Jan 7;362(1):18-26.
69. 69. Yeung LL, Grewal S, Bullock A, Lai HH, Brandes SB. A comparison of chlorhexidine-alcohol versus povidone-iodine for eliminating skin flora before genitourinary prosthetic surgery: a randomized controlled trial. J Urol. 2013 Jan;189(1):136-40.
70. 70. Tanner J, Woodings D, Moncaster K. Preoperative hair removal to reduce surgical site infection. Cochrane Database Syst Rev. 2006 Apr 19;(2):CD004122. doi: 10.1002/14651858.CD004122.pub2. Update in: Cochrane Database Syst Rev. 2006 Jul 19;(3):CD004122.
71. 71. Palmisano F, Boeri L, Cristini C, Antonini G, Spinelli MG, Franco G, et al. Comparison of Infrapubic vs Penoscrotal Approaches for 3-Piece Inflatable Penile Prosthesis Placement: Do We Have a Winner? Sex Med Rev. 2018 Oct;6(4):631-639.
72. 72. Siegrist, T.C., Kwon, E.O., Fracchia, J.A. and Eid, J.F. No touch technique: a novel technique for reducing postoperative infections in patients receiving multicomponent inflatable penile prostheses. Journal of Urology. 2008 Apr 1 ;179(4S):404.
73. 73. Eid JF, Wilson SK, Cleves M, Salem EA. Coated implants and "no touch" surgical technique decreases risk of infection in inflatable penile prosthesis implantation to 0.46%. Urology. 2012 Jun;79(6):1310-5.
74. 74. Carson CC 3rd. Efficacy of antibiotic impregnation of inflatable penile prostheses in decreasing infection in original implants. J Urol. 2004 Apr;171(4):1611-4. Erratum in: J Urol. 2004 Aug;172(2):781.
75. 75. Wolter CE, Hellstrom WJ. The hydrophilic-coated inflatable penile prosthesis: 1-year experience. J Sex Med. 2004 Sep;1(2):221-4.
76. 76. Serefoglu EC, Mandava SH, Gokce A, Chouhan JD, Wilson SK, Hellstrom WJ. Long-term revision rate due to infection in hydrophilic-coated inflatable penile prostheses: 11-year follow-up. J Sex Med. 2012 Aug;9(8):2182-6.
77. 77. Lokeshwar SD, Bitran J, Madhusoodanan V, Kava B, Ramasamy R. A Surgeon's Guide to the Various Antibiotic Dips Available During Penile Prosthesis Implantation. Curr Urol Rep. 2019 Jan 30;20(2):11. doi: 10.1007/s11934-019-0874-8.
78. 78. O'Rourke TK Jr, Erbella A, Zhang Y, Wosnitzer MS. Prevention, identification, and management of post-operative penile implant complications of infection, hematoma, and device malfunction. Transl Androl Urol. 2017 Nov;6(Suppl 5):S832-S848.
79. 79. Osmonov D, Ragheb AM, Petry T, Eraky A, Bettocchi C, Lamers KG, et al. Value of prolonged scrotal drainage after penile prosthesis implantation: a multicenter prospective nonrandomized pilot study. Int J Impot Res. 2023 May 11.
80. 80. Pozza D, Pozza M, Musy M, Pozza C. 500 penile prostheses implanted by a surgeon in Italy in the last 30 years. Arch Ital Urol Androl. 2015 Sep 30;87(3):216-21.
81. 81. Wosnitzer MS, Greenfield JM. Antibiotic patterns with inflatable penile prosthesis insertion. J Sex Med. 2011 May;8(5):1521-8.
82. 82. Dropkin BM, Chisholm LP, Dallmer JD, Johnsen NV, Dmochowski RR, Milam DF, Kaufman MR. Penile Prosthesis Insertion in the Era of Antibiotic Stewardship-Are Postoperative Antibiotics Necessary? J Urol. 2020 Mar;203(3):611-614.
83. 83. Adamsky MA, Boysen WR, Cohen AJ, Ham S, Dmochowski RR, Faris SF, et al. Evaluating the Role of Postoperative Oral Antibiotic Administration in Artificial Urinary Sphincter and Inflatable Penile Prosthesis Explantation: A Nationwide Analysis. Urology. 2018 Jan;111:92-98..
84. 84. Selph JP, Carson CC 3rd. Penile prosthesis infection: approaches to prevention and treatment. Urol Clin North Am. 2011;38(2):227–235.
85. 85. Mulcahy JJ. Treatment alternatives for the infected penile implant. Int J Impot Res. 2003 Oct;15 Suppl 5:S147-9.
86. 86. Mulcahy JJ. Long-term experience with salvage of infected penile implants. J Urol. 2000 Feb;163(2):481-2.
87. 87. 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 Mar;195(3):694-7.
88. 88. Köhler TS, Modder JK, Dupree JM, Bush NC, McVary KT. Malleable implant substitution for the management of penile prosthesis pump erosion: a pilot study. J Sex Med. 2009 May;6(5):1474-8.
89. 89. Corona G, Santi D, Cocci A, Vena W, Pizzocaro A, Vignozzi L,et al. Long-term penile prosthesis couple's satisfaction: A systematic review and meta-analysis. Andrology. 2024 Jul 16.
90. 90. Bostancı, C. Penis protezleri: 10 yıllık Hacettepe deneyimi. Uzmanlık tezi. Ankara: Hacettepe Üniversitesi, 1998.