Perioperative Prevention of Penile Prosthesis Infection: Practice Patterns among Surgeons of SMSNA and ISSM

• Published in: Journal of sexual medicine Vol. 9; no. 6; pp. 1705 - 1714
• Main Authors: Katz, Darren J., Stember, Doron S., Nelson, Christian J., Mulhall, John P.
• Format: Journal Article
• Language: English
• Published: Malden, USA Elsevier Inc 01-06-2012; Blackwell Publishing Inc
• Subjects: Antibiotic Prophylaxis; Antibiotic Selection; Erectile Dysfunction; Erectile Dysfunction - surgery; Europe; Health Care Surveys; Humans; Infection; Inflatable Penile Prosthesis; Latin America; Male; North America; Penile Prosthesis - adverse effects; Perioperative Care; Practice Pattern Survey; Practice Patterns, Physicians; Prosthesis-Related Infections - prevention & control; Survey of Urologists; Three-Piece Penile Implant; Urology - education; North America; Europe; Latin America; Infection; Erectile Dysfunction; Survey of Urologists; Inflatable Penile Prosthesis; Practice Pattern Survey; Three-Piece Penile Implant; Antibiotic Selection
• ISSN: 1743-6095; 1743-6109
• DOI: 10.1111/j.1743-6109.2012.02724.x

Anecdotally, there is great variation in the use of strategies to prevent postoperative penile implant infection.
To evaluate the perioperative practice patterns of surgeons who insert penile prostheses focusing on their respective infection control routines.
An anonymous Web-based survey was sent to members of the Sexual Medicine Society of North America (SMSNA) and the International Society of Sexual Medicine (ISSM).
Thirty-nine questions were asked pertaining to the strategies used during the pre-, intra-, and postoperative phases of penile implant surgery to prevent infection.
One hundred twenty-nine surgeons responded to the survey (SMSNA 84; ISSM 45). Most surgeons considered themselves sexual medicine specialists. More SMSNA respondents had inserted >100 prosthesis (SMSNA 69%, ISSM 50%). Routine urine culture is not performed by 40% and 50% of SMSNA and ISSM members, respectively. Similar percentages of surgeons from each society request a daily preoperative antimicrobial scrub. About two-thirds of ISSM members use razors for the preoperative shave compared with one-third of SMSNA members. Most ISSM surgeons preferred povidone-iodine for hand and skin preparation while most SMSNA surgeons chose this only for skin preparation. Two-thirds of SMSNA members prepared the skin for at least 10 minutes compared with 34% of ISSM surgeons. There were considerable differences in all aspects of antibiotic usage not only between members of both societies but also among individual members of each society. Most surgeons prefer not to place a drain (SMSNA 70%, ISSM 81%). Discharge timing differs between the two groups.
There is great variation in perioperative strategies utilized to prevent penile implant infections including some key differences between surgeons from SMSNA and ISSM. It is unknown if these variations result in changes in the postoperative infection rate; however, the study data may assist in the formation of practice guidelines and form the basis of future prospective studies. Katz DJ, Stember DS, Nelson CJ, and Mulhall JP. Perioperative prevention of penile prosthesis infection: Practice patterns among surgeons of SMSNA and ISSM. J Sex Med 2012;9:1705–1714.