Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee.
Vanderbilt University School of Medicine, Nashville, Tennessee.
J Urol. 2020 Mar;203(3):611-614. doi: 10.1097/JU.0000000000000578. Epub 2019 Oct 3.
We sought to determine whether patients discharged from the hospital without antibiotics after inflatable penile prosthesis insertion were at increased risk for infectious complications compared to patients at our institution discharged with oral antibiotics and patients in other contemporary series.
We reviewed the medical records of patients who underwent inflatable penile prosthesis insertion from 2013 through 2017. Group 1 patients had no risk factors for infectious complications and did not receive postoperative antibiotics. Group 2 patients had risk factors for infectious complications but did not receive postoperative antibiotics. Group 3 patients had risk factors for infectious complications and received postoperative antibiotics.
Of the 222 men who met study inclusion criteria 88 (40%) were in group 1, 48 (21%) were in group 2 and 86 (39%) were in group 3. The mean ± SD number of risk factors for infection was lower in group 2 than in group 3 (1.08 ± 0.28 vs 1.24 ± 0.46, p = 0.013). Median followup did not vary among groups 1, 2 and 3 (4.6 months, IQR 1.8-7.2; 3.5, IQR 1.4-6.9; and 4.5, IQR 1.4-7.4; p = 0.146, respectively). Rates of explantation due to device infection (0% vs 4% vs 5%, p = 0.130) and nonoperative infectious complications (1% vs 2% vs 2%, p = 0.829) did not vary among groups 1 to 3, respectively.
Patients who undergo inflatable penile prosthesis insertion appeared unlikely to benefit from routine administration of postoperative antibiotics. In the current era of antibiotic stewardship these findings have the potential for substantial individual and population health benefits.
我们旨在确定与本机构出院时口服抗生素的患者和其他当代系列患者相比，置入可膨胀阴茎假体后出院时未使用抗生素的患者是否存在感染性并发症的风险增加。
我们回顾了 2013 年至 2017 年间接受可膨胀阴茎假体置入的患者的病历。第 1 组患者无感染性并发症的危险因素，且未接受术后抗生素治疗。第 2 组患者有感染性并发症的危险因素，但未接受术后抗生素治疗。第 3 组患者有感染性并发症的危险因素，且接受了术后抗生素治疗。
在符合研究纳入标准的 222 名男性中，88 名（40%）为第 1 组，48 名（21%）为第 2 组，86 名（39%）为第 3 组。第 2 组的感染危险因素的平均（± SD）数量低于第 3 组（1.08 ± 0.28 比 1.24 ± 0.46，p = 0.013）。第 1、2 和 3 组的中位随访时间无差异（4.6 个月，IQR 1.8-7.2；3.5，IQR 1.4-6.9；4.5，IQR 1.4-7.4；p = 0.146）。因器械感染而取出的比例（0%比 4%比 5%，p = 0.130）和非手术性感染性并发症的比例（1%比 2%比 2%，p = 0.829）在第 1 至 3 组之间无差异。
接受可膨胀阴茎假体置入的患者似乎不会从常规使用术后抗生素中获益。在当前抗生素管理的时代，这些发现有可能对个人和人群健康带来重大益处。
