Boston University Medical Center, Boston, MA, USA.
NorCal Urology Medical Group, Oakland, CA, USA.
Int J Impot Res. 2022 Jan;34(1):81-85. doi: 10.1038/s41443-020-00368-6. Epub 2020 Nov 9.
Penile prosthesis implantation is a safe and effective treatment option in the management of erectile dysfunction, associated with high satisfaction and low complication rates. Infection is a rare complication (0.5-3%), but devastating for the patient and surgeon when it occurs. Adapting from other surgical disciplines, we have utilized vancomycin paste to provide prolonged focal antibiotic exposure around the penile prosthesis pump, a site prone to infection. The aim of this study is to determine the safety and efficacy of intraoperative vancomycin paste with regards to infection prevention during penile prosthesis placement. This is a multi-institutional nonrandomized retrospective IRB-approved study comparing patients who underwent placement of a primary inflatable penile prosthesis with intraoperative vancomycin paste to those without. Primary outcomes included pump fibrosis, infection, erosion, hematoma, and complete device malfunction. From April 2019 to October 2019, two surgeons utilized vancomycin paste intraoperatively during virginal penile prosthesis surgery on 90 patients, whose mean age was 60 years. These patients were compared to an historical control group that included 166 patients, also with a mean age of 60 years, who underwent the same penile prosthesis surgery between 2014 and 2017 without the paste. Among the intervention group, the overall complication rate was 1.1%, due to a scrotal hematoma. Ultimately, there was no statistically significant difference in infection rate (0% in both groups) or overall complication rate (1.1% in the intervention group compared to 1.2% in the control group). The use of vancomycin paste appears to be safe, however future prospective studies are needed to determine its efficacy in infection prevention.
阴茎假体植入术是治疗勃起功能障碍的一种安全有效的治疗选择，其满意度高，并发症发生率低。感染是一种罕见的并发症（0.5-3%），但一旦发生，对患者和外科医生来说都是灾难性的。借鉴其他外科专业，我们使用万古霉素糊剂在阴茎假体泵周围提供长时间的局部抗生素暴露，这是一个容易感染的部位。本研究旨在确定术中使用万古霉素糊剂预防阴茎假体放置过程中感染的安全性和有效性。这是一项多机构、非随机、回顾性 IRB 批准的研究，比较了接受原发性可膨胀阴茎假体植入术且术中使用万古霉素糊剂的患者与未使用万古霉素糊剂的患者。主要结局包括：泵纤维化、感染、侵蚀、血肿和完全装置故障。2019 年 4 月至 2019 年 10 月，两名外科医生在 90 名原发性勃起功能障碍患者的阴茎假体手术中使用了万古霉素糊剂，这些患者的平均年龄为 60 岁。这些患者与一组历史对照患者进行了比较，该组包括 166 名患者，他们的平均年龄也为 60 岁，在 2014 年至 2017 年期间接受了相同的阴茎假体手术，但没有使用糊剂。在干预组中，总并发症发生率为 1.1%，原因是阴囊血肿。最终，两组的感染率（均为 0%）或总并发症发生率（干预组为 1.1%，对照组为 1.2%）均无统计学差异。万古霉素糊剂的使用似乎是安全的，但需要进一步前瞻性研究来确定其在预防感染方面的疗效。
