Prospective evaluation of neomycin serum concentrations after direct corpora cavernosa irrigation during penile prosthesis placement.
OBJECTIVE
To determine if toxic serum levels of neomycin are generated after direct corpora cavernosa irrigation during penile prosthesis placement.


METHODS
We have used an infection prophylaxis technique that involves directly irrigating the corpora cavernosa tissue (through the corporotomy) with 0.5% neomycin solution. Serum neomycin concentrations were measured at 1 hour and 4 hours after irrigation in 13 patients undergoing penile prosthesis placement. A subset of patients who had preimplant and postimplant serum creatinine concentrations was evaluated for changes in renal function.


RESULTS
The mean 1-hour postirrigation serum neomycin level was 1.2 micrograms/mL and the mean 4-hour postirrigation level was 1.2 micrograms/mL. These serum neomycin concentrations are lower than those thought to be necessary to produce nephrotoxicity or ototoxicity. Renal function was not significantly affected by the neomycin irrigation.


CONCLUSIONS
Although aminoglycosides are ototoxic and neomycin has the highest nephrotoxic potential of the aminoglycosides, we conclude that direct irrigation of the corpora cavernosa with 0.5% neomycin solution does not produce significant systemic exposure to result in nephrotoxicity or ototoxicity. One-time prophylactic neomycin irrigation remains an effective, safe, and economic adjunct to penile prosthesis placement.
Pickard
J L
JL
Department of Surgery, University of Missouri-Columbia School of Medicine, USA.
Phillips
J O
JO
Weinstein
S H
SH
Holloway
W R
WR
D003404:Creatinine / Q000097:blood; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009355:Neomycin / Q000097:blood*; D015917:Penile Prosthesis; D011446:Prospective Studies; D012189:Retrospective Studies; D007507:Therapeutic Irrigation; D013997:Time Factors
D003404:Creatinine; D009355:Neomycin