212 The Relationship Between Infection Severity, Microorganisms, and Surgical Intervention in Inflatable Penile Prosthesis Infections

Inflatable penile prosthesis (IPP) infection presents in many forms and results in myriad treatment choices for prosthetic urologic surgeons. We reviewed our multi-institution database of IPP infections to examine for patterns regarding organisms discovered at salvage or explant surgery and interventions deemed necessary by contributing surgeons based on severity of infection. This is a retrospective IRB-approved analysis of 213 patients at 25 institutions who underwent salvage procedure or device explant between 2001 and 2016. Patient data were compiled after extensive review of operative reports, nursing operative data, intraoperative wound cultures, perioperative antibiotics, inpatient notes, consult notes, and follow-up visits. Of 7 anaerobic infections, 5 devices underwent successful malleable implant salvage (71%). The other 2 devices were explanted. Only 1 of the patients had a previous implant surgery, the other six were primary implants. Of 62 Gram positive infections, 25 devices underwent successful malleable implant salvage (40%), 22 were explanted (35%), and 15 underwent classic Mulcahy salvage (24%). Forty-seven patients had previous implant surgery, the other 15 were primary implants. Of 14 fungal infections, 4 underwent malleable implant salvage (40%), 4 devices were explanted (40%), and 4 were salvaged in the classic Mulcahy technique (20%). Four patients had previous implant surgery, the other 10 were primary implants. Of 39 fungal infections, 10 underwent malleable implant salvage (26%), 16 devices were explanted (41%), and 13 were salvaged in the classic Mulcahy technique (33%). Twenty-four patients had previous implant surgery, the other 15 were primary implants. Three artificial urinary sphincters were implanted simultaneously with IPPs in this series and all 3 cases developed Gram negative infections.