Kaufman J M, Kaufman J L, Borges F D
J Urol. 1998 Mar;159(3):816-8.
The most devastating complication after the insertion of a penile prosthesis is the development of infection. The standard approach involves removing the entire device, treating intensively with antibiotics and attempting to reinsert a prosthesis at a later date, often with a suboptimal result. Based on the encouraging results of others, during the last 24 months we have used in 2 separate private urological practices a salvage procedure for treatment of infected inflatable penile prostheses.
The protocol used in 7 men with an infected inflatable penile prosthesis included removal of all device components, a 7-step vigorous intraoperative irrigation with 4 different solutions, including vancomycin, immediate reimplantation of a new inflatable penile prosthesis and postoperative outpatient antibiotics with oral ciprofloxacin or intravenous vancomycin or cefazolin.
Of the 7 men 6 have experienced excellent results with no infection, minimal morbidity and preservation of penile length. The only failure occurred in a poorly controlled diabetic who required multiple revisions and may have had latent infection for months before it became apparent.
We believe that an immediate salvage procedure for an infected inflatable penile prosthesis is an effective treatment for this difficult complication.
阴茎假体植入术后最严重的并发症是感染。标准的处理方法包括取出整个装置，强化使用抗生素治疗，并尝试在日后重新植入假体，但结果往往不尽人意。基于其他人令人鼓舞的结果，在过去24个月里，我们在两家独立的私人泌尿外科诊所采用了一种挽救手术来治疗感染的可膨胀阴茎假体。
7名感染可膨胀阴茎假体的男性所采用的方案包括取出所有装置部件，术中用4种不同溶液（包括万古霉素）进行7步强力冲洗，立即重新植入新的可膨胀阴茎假体，以及术后门诊使用口服环丙沙星或静脉注射万古霉素或头孢唑林进行抗生素治疗。
7名男性中有6名取得了极佳的效果，没有感染，发病率极低，阴茎长度得以保留。唯一的失败案例发生在一名血糖控制不佳的糖尿病患者身上，他需要多次修复，并且在感染明显之前可能已经潜伏感染了数月。
我们认为，对于感染的可膨胀阴茎假体立即采用挽救手术是治疗这种棘手并发症的有效方法。
