Penile Prosthesis Salvage: Review of Past and Current Practices

This review highlights landmark studies and recent literature regarding penile implant salvage in the setting of infection. We discuss both the historically relevant treatments and newest trends in current practice.

The most recent studies indicate that most penile prosthesis infections can be managed with explantation and washout with immediate implantation of malleable prosthesis. This technique allows for prevention of corporal fibrosis and possible transition to future inflatable penile prosthesis.

While prosthetic infection rates have declined over the years, a 1–3% risk still remains. Originally, prosthetic infections were treated by immediate explantation with consideration for re-implantation months later once the acute period for infection had been managed with broad spectrum antibiotics. However, a landmark study by Mulcahy in 1996 advocated for explantation, antibiotic-based washout, and immediate re-implantation. More recent studies have favored a malleable implant salvage technique (MIST) to preserve penile length. This technique includes explantation, washout, and immediate malleable prosthesis insertion. Further, some researchers are now examining use of temporary intracorporal antibiotic-infused calcium sulfate paste in the setting of implant salvage.