Successful Conservative Therapy for Infected Penile Implants: A Case Series.

ABSTRACT

BACKGROUND Traditionally, penile implant infections have been treated by removal followed by immediate or delayed replacement. The use of antibiotics in conservative therapy has recently attracted attention. CASE REPORT We report our experience with 4 cases of infected penile implants managed conservatively. Case 1 was a 41-year-old with sickle cell anemia who presented with low-grade fever and purulent discharge that started 1 month postoperatively and lasted for 3 weeks. He had left graft after fibrotic tissue excision with 14-mm collection in the left corpus cavernosum. He was managed with IV pipracillin/tazobactam and vancomycin for 13 days. Follow-up after 23 weeks showed complete wound healing. Case 2 was a 62-year-old with diabetes who had purulent discharge that started 41 days postoperatively and lasted for 1 week. He received 5 days of IV vancomycin and gentamycin. Follow-up after 4 weeks showed marked improvement of the wound. Case 3 was a 61-year-old with diabetes and ischemic heart disease. He presented 30 days postoperatively with fever, purulent discharge for 5 days. He received a total of 10 days of IV vancomycin and gentamycin. Follow-up 3 weeks after discharge showed complete wound healing. Case 4 was a 61-year-old with diabetes and ischemic heart disease. He presented 1 month postoperatively with fever and pus discharge for 1 week. He completed 10 days of IV vancomycin and gentamycin. Follow-up after 1 week showed marked wound healing. CONCLUSIONS Choosing patients with early superficial infected penile prosthesis for conservative management should be tailored to selected patients who does not have leukocytosis, signs of sepsis, high-grade fever, or an exposed device.