title: Isolated infection of a decommissioned penile prosthesis reservoir with Actinomyces neuii.
abstract: BACKGROUND
  Inflatable penile prostheses (IPPs) are a well-established and reliable treatment for medication refractory erectile dysfunction. The most serious complication with IPPs is infection, with the reported incidence after primary placement 1% to 3% and after revision surgery 8% to 18%.
  
  
  OBJECTIVE
  The aim of this report is to describe an infected decommissioned IPP reservoir with Actinomyces neuii with successful preservation of a functioning implant.
  
  
  METHODS
  After 9 years of successful use with an IPP (AMS 700 CX) for Peyronie's disease and organic erectile dysfunction, a 79-year-old man underwent replacement with an AMS 700 LGX. The decommissioned reservoir was kept in the right prevesical space, and the new reservoir was placed in the left prevesical space. Three months later, he presented with right inguinal pain and swelling.
  
  
  RESULTS
  He was found to have an infected right reservoir with A. neuii, sparing his new IPP. After removal of the right reservoir, he had an uneventful recovery and has shown no evidence of infection in the new device.
  
  
  CONCLUSIONS
  Revision surgery for IPPs carries a higher risk for implant infection. This is the first report of a genitourinary implant infection with A. neuii. Aggressive surgical and medical treatment may allow preservation of the functioning implant, despite gross infection of the decommissioned reservoir.
authors.affiliation: Department of Urology, University of Washington School of Medicine, Seattle, WA 98195, USA.
authors.forename: Ryan S
authors.initials: RS
authors.lastname: Hsi
authors.forename: James M
authors.initials: JM
authors.lastname: Hotaling
authors.forename: Elysia S
authors.initials: ES
authors.lastname: Spencer
authors.forename: Paul L
authors.initials: PL
authors.lastname: Bollyky
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Walsh
mesh_terms: D000190:Actinomyces; D000196:Actinomycosis / Q000209:etiology* / Q000382:microbiology / Q000601:surgery; D000368:Aged; D007172:Erectile Dysfunction / Q000601:surgery; D006801:Humans; D008297:Male; D010411:Penile Induration / Q000601:surgery; D015917:Penile Prosthesis / Q000009:adverse effects* / Q000382:microbiology; D016459:Prosthesis-Related Infections / Q000209:etiology / Q000382:microbiology*