Department of Urology, Wake Forest Baptist Medical Center, Winston-Salem, NC, USA.
Investig Clin Urol. 2018 Sep;59(5):342-347. doi: 10.4111/icu.2018.59.5.342. Epub 2018 Jul 25.
Primary care providers harbor misconceptions regarding penile prosthetic surgery, largely overestimating the rate of infection. Rates of infection following surgery for primary placement and revision are estimated as 1% to 3% and 10% to 18%, respectively. Our objective was to determine the contemporary incidence of infection following inflatable penile prostheses surgery at an academic training center where surgeons-in-training are routinely involved.
Review of a prospectively collected single-surgeon database was performed. All cases of inflatable penile prostheses placement from January 2011 through June 2017 were reviewed. Information regarding training level of assistant surgeon(s) was collected, and follow-up data was compiled regarding postoperative infections and need for revision surgery.
Three hundred nine cases meeting inclusion criteria were identified. Mean patient age was 64.2 years, and mean follow-up was 28.7 months. Distribution involved 257 (83.2%) for primary placement, 45 (14.6%) for removal/replacement, and 7 (2.3%) in setting of prior device removal. Diabetes was noted in 31.1% of men. Surgeon-in-training involvement was noted in 100% of cases. Infection was confirmed in a patient who had skin breakdown over an area of corporal reconstruction with polytetrafluoroethylene. The overall postoperative infection rate was 0.3%.
In this series from an academic training center, infection following penile prosthetic surgery is low, similar to other centers of excellence, even with 100% involvement of surgeons-in-training. This data should be used to better inform primary care providers and members of the general public potentially interested in restoration of sexual function.
初级保健提供者对阴茎假体手术存在误解,主要是高估了感染率。初次手术和翻修手术的感染率估计分别为 1%至 3%和 10%至 18%。我们的目的是确定在学术培训中心,当外科医生培训生常规参与时,充气式阴茎假体手术后感染的当代发生率。
对前瞻性收集的单外科医生数据库进行了回顾。回顾了 2011 年 1 月至 2017 年 6 月期间所有充气阴茎假体放置的病例。收集了辅助外科医生(们)培训水平的信息,并汇编了术后感染和需要翻修手术的随访数据。
确定了符合纳入标准的 309 例病例。患者平均年龄为 64.2 岁,平均随访时间为 28.7 个月。分布情况涉及 257 例(83.2%)为初次放置,45 例(14.6%)为取出/更换,7 例(2.3%)为先前设备取出。31.1%的男性患有糖尿病。100%的病例都有外科医生培训生参与。感染发生在一名接受聚四氟乙烯重建体皮肤破裂的患者身上。总的术后感染率为 0.3%。
在这个来自学术培训中心的系列中,阴茎假体手术后感染率较低,与其他卓越中心相似,即使有 100%的外科医生培训生参与。这些数据应用于更好地告知初级保健提供者和对性功能恢复感兴趣的公众。