Penile prosthesis implantation is a safe and effective treatment option in the management of
erectile dysfunction, associated with high satisfaction and low complication rates.
Infection is a rare complication (0.5-3%), but devastating for the patient and surgeon when it occurs. Adapting from other surgical disciplines, we have utilized
vancomycin paste to provide prolonged focal
antibiotic exposure around the
penile prosthesis pump, a site prone to
infection. The aim of this study is to determine the safety and efficacy of intraoperative
vancomycin paste with regards to
infection prevention during
penile prosthesis placement. This is a multi-institutional nonrandomized retrospective IRB-approved study comparing patients who underwent placement of a primary inflatable
penile prosthesis with intraoperative
vancomycin paste to those without. Primary outcomes included pump
fibrosis,
infection, erosion,
hematoma, and complete device malfunction. From April 2019 to October 2019, two surgeons utilized
vancomycin paste intraoperatively during virginal
penile prosthesis surgery on 90 patients, whose mean age was 60 years. These patients were compared to an historical control group that included 166 patients, also with a mean age of 60 years, who underwent the same
penile prosthesis surgery between 2014 and 2017 without the
paste. Among the intervention group, the overall complication rate was 1.1%, due to a scrotal
hematoma. Ultimately, there was no statistically significant difference in
infection rate (0% in both groups) or overall complication rate (1.1% in the intervention group compared to 1.2% in the control group). The use of
vancomycin paste appears to be safe, however future prospective studies are needed to determine its efficacy in
infection prevention.