Immediate salvage procedure for infected penile prostheses: A review of the advances in surgical technique and antimicrobial strategies
摘要
Penile prostheses (PPs) implantation represents a reliable treatment option for refractory erectile dysfunction (ED), yet post-operative infection remains a significant clinical challenge. Traditional management necessitates device explantation, resulting in a period of complete loss of erectile function and often a challenging delayed re-implantation due to resultant corporal scarring and penile shortening. Immediate salvage procedures, encompassing device removal followed by thorough antimicrobial washout and immediate re-implantation, offer substantial advantages with regard to penile length preservation, patient satisfaction, healthcare costs, and overall outcomes. Despite these benefits, immediate salvage procedures remain underutilized in clinical practice. Since the introduction of the Mulcahy’s salvage protocol by Brant and his colleagues in 1996, numerous urologists have adopted the immediate salvage approach, reporting comparable or even superior infection-free success rates. Based on thirteen studies published over the past three decades, this review comprehensively examines their reported recent advancements in immediate salvage techniques, covering surgical innovations and evolving antimicrobial strategies.