Advanced Urologic Care, New York, NY, USA.
Urology. 2012 Jun;79(6):1310-5. doi: 10.1016/j.urology.2011.11.076. Epub 2012 Apr 21.
To explore whether a "no touch" enhancement to the surgical technique of inflatable penile prosthesis (IPPs) implantaion will further decrease infection rates.
A single surgeon performed 2347 IPPs between January 2002 and June 2011. Patients receiving each manufacturer's implants were stratified for age and diabetes. Since 2003, infection retardant-coated IPPs were implanted through the standardized penoscrotal approach. Since 2006, the "no touch" enhancement was added to the surgical procedure. Infection rates in the noncoated IPP, coated IPP with standard technique, and coated IPP implanted with "no touch" enhancement were calculated and subjected to statistical analysis. The two company's implants were scrutinized for their individual infection rates in each group.
Patients in all the groups were similar for age and diabetes. 132 noncoated implants had an infection rate of 5.3%. In the years 2003-2005, 704 coated devices had a statistically significant improvement in incidence of infection to 2%. In the years 2006-2010, the "no touch" technique enhanced the standard surgical procedure in 1511 patients. Only 7 infections were seen yielding an infection incidence of 0.46%. There was no difference in the two manufacturer's infection rates. Differentiation between virgin and revision operation displayed no bias in the infection rate.
Infection-retardant coatings lower the risk of infection from 5.3% to 2%. The "no touch" enhancement to the surgical procedure further decreases the rate of infection to 0.46%. Neither manufacturer showed statistical superiority in survival from revision for infection.
探讨在可膨胀阴茎假体(IPP)植入术中增加“不接触”增强是否会进一步降低感染率。
一位外科医生于 2002 年 1 月至 2011 年 6 月期间进行了 2347 例 IPP 手术。根据年龄和糖尿病对接受每个制造商的植入物的患者进行分层。自 2003 年以来,使用抗感染涂层的 IPP 通过标准化的阴茎阴囊入路进行植入。自 2006 年以来,在手术过程中增加了“不接触”增强。计算并对非涂层 IPP、标准技术涂层 IPP 和“不接触”增强涂层 IPP 的感染率进行了统计分析。对两组植入物的每个组的单独感染率进行了审查。
所有组的患者年龄和糖尿病相似。132 个未涂层植入物的感染率为 5.3%。在 2003-2005 年期间,704 个涂层装置的感染发生率有统计学意义的改善,降至 2%。在 2006-2010 年期间,1511 例患者采用“不接触”技术增强了标准手术。仅发现 7 例感染,感染发生率为 0.46%。两个制造商的感染率没有差异。初治和翻修手术之间的区别在感染率上没有偏见。
抗感染涂层可将感染风险从 5.3%降低至 2%。手术过程中的“不接触”增强可将感染率进一步降低至 0.46%。两个制造商在因感染而进行翻修的存活率方面均无统计学优势。