Penile implant infection: what patients should know

Of all the risks of penile implant surgery, infection is the one that most changes the outcome. Because the device is a foreign body, an established infection involving it usually cannot be cleared with antibiotics alone. That single fact shapes everything about how implant surgery is prepared for and performed.

How infection is prevented

• Screening for and treating urinary or other infection before surgery is scheduled. Implant surgery is not performed in the presence of an active infection.
• Optimising blood glucose control in men with diabetes before the operation.
• Intravenous antibiotics given before the skin incision.
• Antibiotic-loaded or antibiotic-impregnated device surfaces. Coloplast uses a hydrophilic coating the team loads with antibiotic solution at surgery; Boston Scientific offers InhibiZone, impregnated during manufacture.
• A no-touch or minimal-touch surgical technique, limited theatre traffic, and careful skin preparation.
• A short postoperative antibiotic course, per your surgeon’s protocol.

The signs to act on

Some swelling, bruising and soreness are expected in the first one to two weeks. What is not expected is any of the following:

• Pain that increases rather than settles after the first few days.
• Redness spreading outward from the wound.
• Fever or feeling systemically unwell.
• Discharge, particularly cloudy or foul-smelling, from the wound.
• A component becoming newly prominent or the skin over it looking thin or tethered.

How an infected device is treated

Treatment depends on how early it is caught and how the infection presents. In general, an infection involving the device means the device has to be removed. In selected cases a salvage procedure is possible, where the device is removed, the space thoroughly washed out, and a new device implanted during the same operation. Where salvage is not appropriate, the device is removed and reimplantation is considered later, once the infection has resolved.

What raises your individual risk

Poorly controlled diabetes, immunosuppression, revision surgery, previous device infection, and an active infection elsewhere in the body are all relevant. These are exactly the factors a proper preoperative assessment exists to identify — which is one reason to be cautious about any pathway that offers surgery without one.