We initiated a prospective study of penile prosthesis implant surgery to
evaluate risk factors for infection and other complications. Twenty-one
patients admitted for surgery or related complications were evaluated over a
seven-month period. The two types of penile prostheses implanted were (1)
inflatable and (2) semirigid. Nine of 21 patients (43%) developed
postoperative complications. Although cephapirin and gentamicin were given
prophylactically, four of nine patients had four wound infections and one
case of pneumonia. One case of Bacteroides fragilis
bacteremia was due to stool incontinency during surgery. In two of the wound
infections, removal and reinsertion of the prosthesis was necessary. Other
complications included hypotension during surgery, prosthesis malfunction
and malposition, and urethral tears. There were no significant associations
between infection and age, length of surgery, or type of prosthesis used.
These complications contributed to prolonged hospital stay and readmission
(87 extra days for the infected patients at a cost of $44,000). Antibiotic
costs to treat the infections totaled $1,900. Prospective evaluation by
infection control practitioners of various elective surgeries can be useful
in quantitating the complication rate and targeting patients at risk, with
the goal of minimizing hospital costs.