180 Multicenter Investigation on the Influence of Climate in Penile Prosthesis Infection

Studies in other fields have documented a relationship between temperature and surgical site infection. We reviewed our multi-institution database of inflatable penile prosthesis infections to examine the relationship between inflatable penile prosthesis (IPP) infection, culture positivity, time of year, climate, temperature, humidity, and organisms responsible for 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. Climate data were compiled from monthly norms based on location, as well as specific data regarding temperature, dew point, and humidity from dates of surgery. Rigorous statistical analysis was performed. Organisms were cultured from infected devices in 71% of cases, with the following frequency: Gram positive bacteria (44%), Gram negative bacteria (25%), Candida species (8%), and anaerobic bacteria (6%). Infections were more likely to occur in devices placed in spring months (61), although the small sample size and lack of a denominator precluded statistical significance. This was consistent across geographic location, including in the Southern hemisphere. Infections occurred most frequently in IPPs placed in June (24). Fewer infections occurred in IPPs placed in winter months (39), with the lowest number occurring in March (11). There were 58 infections in summer months and 55 in fall months. Over the last 15 years, the rates of culture positivity, as well as the organisms cultured during salvage or explant surgery, have generally remained consistent. There was substantial geographic variation regarding successful growth of organisms in culture.