Al Mohajer Mayar, Darouiche Rabih O
Department of Medicine, University of Arizona, Tucson, AZ, USA.
Spinal Cord Injury and Medical Care Lines, Infectious Disease Section, Michael E. DeBakey and Veterans Affairs Medical Center, Baylor College of Medicine, Houston, TX, USA.
Sex Med Rev. 2014 Oct;2(3-4):134-140. doi: 10.1002/smrj.30. Epub 2015 Oct 19.
The implantation of inflatable penile prosthesis (IPP) has become a successful method for the treatment of erectile dysfunction. Infections are rare but they can result in devastating complications following surgical implantation of the prosthesis.
To discuss pathogenesis, risk factors, and microbiology of IPP infections, summarize clinical manifestation and diagnostic methods, and discuss future directions of prevention and management.
A PubMed search was performed of all articles published from 1960 to present relating to IPP infections.
Skin flora organisms such as Staphylococcus epidermis are the most common source of infection. Several host and surgical risk factors for prosthesis infection have been demonstrated, including uncontrolled diabetes mellitus and previous surgical interventions. Biofilms play an important role in the pathogenesis of device-related infections. Pain, fever, drainage, and device extrusions are suggestive of IPP infection. Preventive methods include preoperative skin cleansing, systemic antibiotic prophylaxis, and the use of surface-modified prostheses. The most frequently utilized surgical management is a single-stage approach that comprises aggressive irrigation and debridement, removal of all components of the infected prosthesis, and placement of a new IPP in the same surgical setting.
Advances in systemic antimicrobial prophylaxis, skin cleansing and surface-modification of the devices, as well as a number of other potentially protective measures, have decreased the rates of infections. Currently, most infected IPP are surgically managed by adopting the salvage approach. Al Mohajer M and Darouiche RO. Infections associated with inflatable penile prostheses. Sex Med Rev 2014;2:134-140.
可膨胀阴茎假体(IPP)植入已成为治疗勃起功能障碍的一种成功方法。感染虽罕见,但假体手术植入后可导致严重并发症。
探讨IPP感染的发病机制、危险因素及微生物学,总结临床表现和诊断方法,并讨论预防和管理的未来方向。
对1960年至今发表的所有与IPP感染相关的文章进行PubMed检索。
表皮葡萄球菌等皮肤菌群是最常见的感染源。已证实假体感染存在多种宿主和手术危险因素,包括糖尿病控制不佳和既往手术干预。生物膜在与器械相关的感染发病机制中起重要作用。疼痛、发热、引流和器械外露提示IPP感染。预防方法包括术前皮肤清洁、全身抗生素预防以及使用表面改性假体。最常用的手术管理方法是单阶段方法,包括积极冲洗和清创、移除感染假体的所有组件,并在同一手术环境中植入新的IPP。
全身抗菌预防、皮肤清洁和器械表面改性以及其他一些潜在保护措施的进展降低了感染率。目前,大多数感染的IPP通过采用挽救方法进行手术管理。Al Mohajer M和Darouiche RO。与可膨胀阴茎假体相关的感染。性医学评论2014;2:134 - 140。