Introduction: Penile prosthesis implant is a safe and effective option in erectile dysfunction patients, being implant procedures safe with a low risk of infection. However, when infection occurs, it represents a concrete problem for both surgeon and patient. Methods: This is a comprehensive review of all issues relating to prosthesis infection, including causes and risk factors, methods of prevention, and management. We analyzed all preoperative and perioperative factors, which can play a role in infection of the device. Results: Infection of penile prosthesis implant is hard to manage and correct. While the incidence of infection following first implant is up to 3%, in cases of re-implant surgery, the rate can reach as high as 18%. Many articles were found addressing prevention and treatment of penile prosthesis infection, and many analyzed all relevant pre- and perioperative factors associated with penile prosthesis implant. Although such factors have been well studied, there is no clear consensus worldwide on certain topics. Conclusions: Penile prosthesis implant is a safe and effective option. Despite infection is a rare event, surgeons should follow strictly pre-, intra- and postoperative recommendations in order to reduce the risk of device’s infection. An appropriate antibiotic therapy should be tailored on patient’s characteristics and pathogens isolated.

1.
NIH consensus conference. Impotence. NIH consensus development panel on impotence
.
JAMA
.
1993
;
270
(
1
):
83
90
.
2.
Lee
DJ
,
Najari
BB
,
Davison
WL
,
Al Hussein Al Awamlh
B
,
Zhao
F
,
Paduch
DA
, et al.
Trends in the utilization of penile prostheses in the treatment of erectile dysfunction in the United States
.
J Sex Med
.
2015
;
12
(
7
):
1638
45
.
3.
Balen
A
,
Gross
MS
,
Phillips
EA
,
Henry
GD
,
Munarriz
R
.
Active polysubstance abuse concurrent with surgery as a possible newly identified infection risk factor in inflatable penile prosthesis placement based on a retrospective analysis of health and socioeconomic factors
.
J Sex Med
.
2016
;
13
(
4
):
697
701
.
4.
Carson
CC
.
Diagnosis, treatment and prevention of penile prosthesis infection
.
Int J Impot Res
.
2003
;
15
(
Suppl 5
):
S139
46
.
5.
Carvajal
A
,
Benavides
J
,
García-Perdomo
H
,
Henry
G
.
Risk factors associated with penile prosthesis infection: systematic review and meta-analysis
.
Int J Impot Res
.
Feb 2020
. .
6.
Xie
D
,
Gheiler
V
,
Lopez
I
,
Nehrenz
GM
,
Klopukh
B
,
Bianco
F
, et al.
Experience with prophylactic gentamicin during penile prosthesis surgery: a retrospective comparison of two different doses
.
J Sex Med
.
2017
;
14
(
9
):
1160
4
.
7.
Gross
MS
,
Phillips
EA
,
Carrasquillo
RJ
,
Thornton
A
,
Greenfield
JM
,
Levine
LA
, et al.
Multicenter investigation of the micro-organisms involved in penile prosthesis infection: an analysis of the efficacy of the AUA and EAU guidelines for penile prosthesis prophylaxis
.
J Sex Med
.
2017
;
14
(
3
):
455
63
.
8.
Gross
MS
,
Reinstatler
L
,
Henry
GD
,
Honig
SC
,
Stahl
PJ
,
Burnett
AL
, et al.
Multicenter investigation of fungal infections of inflatable penile prostheses
.
J Sex Med
.
2019 Jul
;
16
(
7
):
1100
5
.
9.
Carson
CC
,
Mulcahy
JJ
,
Harsch
MR
.
Long-term infection outcomes after original antibiotic impregnated inflatable penile prosthesis implants: up to 7.7 years of followup
.
J Urol
.
2011
;
185
(
2
):
614
8
.
10.
Mandava
SH
,
Serefoglu
EC
,
Freier
MT
,
Wilson
SK
,
Hellstrom
WJ
.
Infection retardant coated inflatable penile prostheses decrease the incidence of infection: a systematic review and meta-analysis
.
J Urol
.
2012 Nov
;
188
(
5
):
1855
60
.
11.
Herati
AS
,
Lo
EM
.
Penile prosthesis biofilm formation and emerging therapies against them
.
Transl Androl Urol
.
2018
;
7
(
6
):
960
7
.
12.
O’Rourke
TK
,
Erbella
A
,
Zhang
Y
, et al.
Prevention, identification, and management of post-operative penile implant complications of infection, hematoma, and device malfunction
.
Transl Androl Urol
.
2017
;
5
:
832
48
.
13.
Henry
GD
,
Wilson
SK
.
Updates in inflatable penile prostheses
.
Urol Clin North Am
.
2007
;
34
(
4
);
535
47
.
14.
Henry
GD
.
The Henry mummy wrap and the Henry finger sweep surgical techniques
.
J Sex Med
.
2009
;
6
(
3
):
619
22
.
15.
Wilson
SK
,
Henry
GD
.
Hematoma formation following penile prosthesis implantation: to drain or not to drain?
J Urol
.
1996
;
55
:
643A
.
16.
Hebert
KJ
,
Kohler
TS
.
Penile prosthesis infection: myths and realities
.
World J Mens Health
.
2019 Sep
;
37
(
3
):
276
87
.
17.
Chlebicki
MP
,
Safdar
N
,
O’Horo
JC
,
Maki
DG
.
Preoperative chlorhexidine shower or bath for prevention of surgical site infection: a meta-analysis
.
Am J Infect Control
.
2013
;
41
(
2
):
167
73
.
18.
Webster
J
,
Osborne
S
.
Preoperative bathing or showering with skin antiseptics to prevent surgical site infection
.
Cochrane Database Syst Rev
.
2015
;(
2
):
CD004985
. .
19.
Blum
MD
.
Infection of genitourinary prosthesis
.
Infect Dis Clin
.
1989
;
3
:
259
74
.
20.
Lotan
Y
,
Roehrborn
CG
,
McConnell
JD
,
Hendin
BN
.
Factors influencing the outcomes of penile prosthesis surgery at a teaching institution
.
Urology
.
2003
;
62
(
5
):
918
21
.
21.
Krzastek
SC
,
Smith
R
.
An update on the best approaches to prevent complications in penile prosthesis recipients
.
Ther Adv Urol
.
2019
;
11
:
1
9
.
22.
Martinez
DR
,
Mennie
PA
,
Carrion
R
.
Erectile function significant enough for penetration during sexual intercourse after removal of inflatable penile prosthesis
.
J Sex Med
.
2012
;
9
(
11
):
2938
42
.
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