Antiseptic lavage after prosthesis removal advised

October 1, 2005

Shreveport, LA--Antiseptic lavage after removal of a penile prosthesis significantly reduces the risk of infection associated with revision surgery, report the authors of a multicenter study.

Antiseptic lavage of the implant spaces was associated with a 3.17% incidence of infection following implantation of a new prosthesis. In contrast, revision surgery without antiseptic lavage of the implant spaces led to infection in 11.6% of patients, according to Gerard D. Henry, MD, a urologist at Regional Urology in Shreveport, La.

"Revision washout of the implant spaces reduces the infection rate by more than half," Dr. Henry told Urology Times. "The results are fantastic, and the procedure has really caught on among urologists."

Initial results from Dr. Henry's study showed that irrigation of the implant space at the time of revision surgery and implantation of an antibiotic-coated replacement prosthesis lowers the risk of infection during revision surgery for noninfectious reasons (J Urol. 2005; 173:89-92).

A more recent report, presented at the AUA annual meeting, provided data from 3-year follow-up to determine whether the early benefits of antiseptic lavage persisted over time.

Infection rate low

The study involved 232 patients with penile prostheses. The patients had revision surgery for noninfectious reasons at three different institutions between June 2001 and May 2004.

Dr. Henry reported that 189 patients had implant removal followed by antiseptic lavage of their implant spaces before replacement with another inflatable prosthesis. In the remaining 43 patients, an antibiotic-coated device was replaced without antiseptic irrigation of the implant spaces.

To date, infection has occurred in six of 189 patients (3.17%) who had antiseptic irrigation before replacement of the penile prosthesis. In contrast, five of 43 patients (11.6%) developed infections following revision surgery without antiseptic lavage of the implant spaces. The difference between groups was statistically significant (p=.037).

"These results clearly show that revision washout after complete implant removal can markedly decrease the incidence of infection in penile prosthesis patients who undergo revision for noninfectious reasons," said Dr. Henry.