title: Penile prosthesis cultures during revision surgery: a multicenter study.
abstract: OBJECTIVE
  Initial implantation of inflatable penile prosthesis has a 3% risk of infection. Reoperation of penile implants has a higher rate of infection, estimated between 10% and 18%. To explain the higher risk in revision surgery in this prospective study we cultured clinically uninfected prostheses requiring revision. Prosthesis pain was also investigated as a predictor of positive culture.
  
  
  METHODS
  At 3 institutions cultures were prospectively obtained from 77 clinically uninfected penile prostheses at revision surgery. Immediately upon surgical exposure of the pump cultures were obtained. If a bacterial biofilm was noted on any component it was additionally cultured. All culture isolates positive for a staphylococcus species were tested for sensitivity to rifampin and tetracycline (minocycline). An implant is now available that is coated with these antibiotics. Patient history of chronic prosthesis pain was ascertained.
  
  
  RESULTS
  Culture positive bacteria were found in 54 of 77 (70%) patients with clinically uninfected penile prostheses. In some patients more than 1 organism grew and, occasionally, the pump culture was negative but the biofilm was positive. Of 54 patients 49 had positive (90%) culture for staphylococcus genus with 10 different species. All staphylococcal species were sensitive to rifampin and/or tetracycline. We did not find a significant association between prosthesis related pain and culture laboratory results.
  
  
  CONCLUSIONS
  The majority of clinically uninfected penile prostheses have organisms growing in the implant spaces at reoperation. Most of these organisms are staphylococcal species that are sensitive to rifampin/minocycline.
authors.affiliation: Institute for Urologic Excellence, Van Buren, Arkansas, USA. GDHenry@hotmail.com
authors.forename: Gerard D
authors.initials: GD
authors.lastname: Henry
authors.forename: Steven K
authors.initials: SK
authors.lastname: Wilson
authors.forename: John R
authors.initials: JR
authors.lastname: Delk
authors.forename: Culley C
authors.initials: CC
authors.lastname: Carson
authors.forename: Ari
authors.initials: A
authors.lastname: Silverstein
authors.forename: Mario A
authors.initials: MA
authors.lastname: Cleves
authors.forename: Craig F
authors.initials: CF
authors.lastname: Donatucci
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010146:Pain / Q000382:microbiology; D015917:Penile Prosthesis / Q000382:microbiology*; D011446:Prospective Studies; D011469:Prostatic Diseases / Q000382:microbiology; D012086:Reoperation; D013210:Staphylococcus / Q000302:isolation & purification*; D013212:Staphylococcus epidermidis / Q000302:isolation & purification