1. Department of Urology, Winthrop University Hospital
Complication and Post-Surgical Infection Rate in AMS’s Inflatable Penile Prosthesis-a Single Surgeon Study
David J. Habibian, Melissa Fazzari, Kosinski E. Kaitlin, Michael Kongnyuy, Aaron E. Katz, Brett C. Mellinger
Department of Urology, Winthrop University Hospital
INTRODUCTION
METHODS
RESULTS cont.
INTRODUCTION
Inflatable penile prosthesis (IPP) have high patient satisfaction rates.
The most serious complication is IPP infection.
Infection rates have decreased with coated IPPs and improved surgical techniques.
American Medical Systems (AMS) IPPs are coated with an antibiotic inhibizone that reduces IPP infections.
The “No Touch” technique eliminates contact between the skin and the implant reducing infection rates.
Modified “No Touch” uses a plastic barrier to cover the penis, frequent glove change and rinsing of the instruments.
An IRB approved retrospective review of patients who underwent implantation of a 3-piece AMS IPP was performed.
Primary (virgin) and secondary (revision) implants for replacement of malfunctioning and infected IPPs were included in the study cohort.
Patients were followed for 6 months (two 3-month intervals during which they were instructed on how to use the device) and thereafter, as needed.
Demographics and co-morbidities were noted.
Associations between patient risk factors and complications were assessed via Fisher’s Exact test.
Risk Factor N
Complication rate
P-value
Diabetes
No Diabetes 74
140
8.11%
6.43%
0.78
Hypertension
No Hypertension
101
113
5.94%
7.96%
0.60
Hyperlipidemia
No Hyperlipidemia 70
144
4.29%
8.33%
0.40
Radical Prostatectomy
No Radical Prostatectomy 25
189
4.00%
7.41%
0.98
Table 2: Association between risk factors and rate of complications in primary AMS IPPs using the No Touch surgical technique.
None of the risk factors for erectile dysfunction were associated with an increased rate of complications.
OBJECTIVES
RESULTS
CONCLUSIONS
We report a single surgeon’s complication and infection rate with inhibizone coated IPP implants via a modified “No Touch” technique.
The combination of the modified “No Touch” surgical technique and the 3-piece AMS inhibizone coated IPP demonstrates an infection rate of 0.5%.
The modified “No Touch” surgery utilizes fewer instruments and less surgical supplies with reduced operative time and potentially reduced cost.
Adherence and proper device selection can significantly reduce postoperative infection rates.
Table 1
Variable
Total
Primary (Virgin)
Secondary (revision)
Other
No. of Patients, n (%)
214 (100)
190 (89)
19 (9)
5 (2)
Hypertension, n (%)
101 (47)
92 (43)
4 (2)
Hyperlipidemia, n (%)
70 (33)
61 (29)
7 (3)
2 (1)
Diabetes, n (%)
74 (35)
63 (29)
8 (4)
3 (1)
Pyronies, n (%)
12 (6)
0 (0)
Radical prostatectomy, n (%)
25 (12)
Radiation therapy, n (%)
Cryotherapy, n (%)
1 (0.5) A
REFERENCES
A total of 221 IPPs were implanted in 214 patients.
The average age was 63.5±12.5 years.
There was a 0.5 % infection rate (1 case) and the most common complication was device malfunction (10 cases).
A majority (89%) of the implants were virgin implants.
Of the 214 patients, 47% and 35% were hypertensive and diabetic respectively.
Only a few patients (12%) were status post radical prostatectomy.
Holland B, Kohler T. Minimizing Penile Implant Infection: A Literature Review of Patient and Surgical Factors. Review. Current Urology Reports. December 2015
Image 1A:
Image 1B: AMS 700 series 3-piece IPP. B
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A 3-piece inhibizone coated AMS IPP for either infrapubic or penoscrotal approach.