To describe the infectious and non-infectious complications in men undergoing IPP revision with partial and complete component exchange for mechanical malfunction.
We performed a multicenter retrospective cohort study of patients who underwent IPP revision.
Men undergoing procedures for implant infection were excluded. Patients were divided into those who had complete exchange of the entire device or partial exchange of only one or two components. Infectious and non-infectious complications were compared between groups.
368 men had complete exchange of the entire device and 85 had partial component exchange. Men undergoing partial exchange had a significantly higher infection rate (7.1% vs 2.2%, p=0.031). The partial exchange group also was more likely to receive antifungals (51.8 vs 16.6%, p<0.001), have a modified salvage washout (77.4 vs 60.2%, p=0.004), and less likely to receive vancomycin and gentamicin (63.5 vs 83.7%, p<0.001). Time to revision was significantly shorter in the partial exchange group (44.9 vs 168.2 months, p<0.001). Mean follow-up was slightly longer in the complete exchange group (18.3 vs 13.0 months). In multivariable analysis, partial exchange surgery, vancomycin and gentamicin prophylaxis, modified salvage washout, and antifungal prophylaxis were no longer associated with postoperative infections. The partial exchange group had greater rates of non-infectious complications (21.2% vs 9.5%, p=0.005) such as pump malfunction and tubing breakage.
Patients undergoing partial component revision had more infectious and non-infectious complications. These findings suggest that partial component exchange increases complications in men undergoing IPP revision.
Urology. 2023 Jan 17 [Epub ahead of print]
David W Barham, Edward Choi, Muhammed Hammad, Daniel Swerdloff, Brittany D Berk, Eric Chung, Jonathan Clavell-Hernandez, Martin S Gross, Lawrence C Jenkins, James McAndrew Jones, Martin N Kathrins, Aaron C Lentz, Joshua Schammel, John Partrick Selph, Jay Simhan, Charles Welliver, Faysal A Yafi
Department of Urology, University of California, Irvine, Orange, CA, USA. Electronic address: ., Department of Urology, University of California, Irvine, Orange, CA, USA. Electronic address: ., Department of Urology, University of California, Irvine, Orange, CA, USA. Electronic address: ., Department of Urology/Urologic Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA. Electronic address: ., Division of Urology, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA. Electronic address: ., Department of Urology, Princess Alexandra Hospital, University of Queensland, QLD, Australia. Electronic address: ., Clavell Urology, Houston, TX, USA; Division of Urology, Department of Surgery, University of Texas McGovern Medical School, Houston, TX, USA. Electronic address: ., Section of Urology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA. Electronic address: ., Department of Urology, University of California, Irvine, Orange, CA, USA. Electronic address: ., Geisel School of Medicine at Dartmouth, Hanover, NH, USA. Electronic address: ., Division of Urology, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA. Electronic address: ., Division of Urology, Department of Surgery, Duke University, Durham, NC, USA. Electronic address: ., Division of Urology, Albany Medical College, Albany, NY, USA. Electronic address: ., Urology Associates of Nashville, Nashville, TN, USA. Electronic address: ., Division of Urology, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA. Electronic address: ., Division of Urology, Albany Medical College, Albany, NY, USA. Electronic address: ., Department of Urology, University of California, Irvine, Orange, CA, USA. Electronic address: .