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Penile prosthesis infection—moving the needle forward: a commentary on risk factors associated with penile prosthesis infection: systematic review and meta-analysis

International Journal of Impotence Research volume 32, pages 635–637 (2020)Cite this article

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The Original Article was published on 03 February 2020

Erectile dysfunction (ED) affects up to 50% of men between the ages of 40 and 70 [1]. In addition to advanced age, other risk factors include tobacco use, poor diet, obesity, low physical activity, and medical comorbidities such as diabetes, hypertension, and cardiovascular disease [2]. Severe ED (“complete impotence”) is less common, yet many patients grapple with ED that is refractory to our first line treatments such as lifestyle modification and oral phosphodiesterase-5 inhibitors [1]. Thankfully, these patients have options, and for most patients the statement, “we can get you an erection, it’s just a matter of determining what we need to do to get you there” rings true. Vacuum erection devices, intracavernosal injections, and intraurethral suppositories are tried and true methods with proven track records regarding safety and efficacy [3]. More recent approaches to “regenerative medicine” have also been popularized including shockwave lithotripsy, stem cells, and platelet rich plasma, although their efficacy in this patient population is unproven [4,5,6]. However, the penile prosthesis, first introduced in 1973, has stood the test of time and remains the gold standard for the patient with medication-refractory ED who desires a rapid and reliable solution [7]. No other therapy has consistently shown such high degrees of efficacy and patient/partner satisfaction [8,9,10].

Penile prosthesis infection is a dreaded complication, and avoiding infection creates substantial anxiety for implanters. A multitude of patient and surgeon-specific factors contribute to the risk for infection [11]. Over the last several decades, advances in device technology and operative technique have been implemented to prevent infection such as antibiotic-impregnated cylinders (or the ability to absorb antibiotics) and the “no-touch” technique [12, 13]. With these and other innovative approaches, current infection rates for primary penile prosthesis placement by high volume implanters are likely in the 1–3% range [11, 12, 14]. Despite these strides, the true influence of pre-, peri-, and postoperative factors on device outcomes is unclear and the majority of the available literature is limited by suboptimal study methodology.

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  1. Department of Urology, Mayo Clinic, Rochester, MN, USA

    Matthew J. Ziegelmann

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Correspondence to Matthew J. Ziegelmann.

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Ziegelmann, M.J. Penile prosthesis infection—moving the needle forward: a commentary on risk factors associated with penile prosthesis infection: systematic review and meta-analysis. Int J Impot Res 32, 635–637 (2020). https://doi.org/10.1038/s41443-020-0250-8

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