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Posted: **Sat Aug 12, 2017 10:08 am**

What is the percentage of infections with an implant and if it does happen what is the treatment? Antibiotics prescribed, the last urologist I saw said my double transplant would not pose a problem other than I may heal slower, any surgery in the past I've healed ok and when I did get an infection I was prescribed Cipro or Kflex
Just wondering.....

Posted: **Sat Aug 12, 2017 10:56 am**

It depends on a lot of things and the doctor and the way they take precautions. Hakky just released me this week to go in a pool, So I have a 4 year old grand daughter here ready to take her Pop to the pool.

Posted: **Sat Aug 12, 2017 11:05 am**

In the last ten years, the overall infection rate has dropped from almost 5% to essentially zero.

If it does happen, Dr. Caesar said if it would not respond to antibiotics he would do a salvage procedure. That's where they remove the entire implant, very thoroughly irrigate with antibiotic solution, and install a new implant. Salvage procedures have been very successful with the extremely rare cases of infection.

This is really nothing to worry about any more.

Posted: **Sat Aug 12, 2017 11:15 am**

Thanks I should be fine with Dr Hakky

Posted: **Sat Aug 12, 2017 11:54 am**

Watch is videos. Ask questions. Tell your wife not to be embarrassed when he calls it a dick. He uses a modified no touch that Eaid uses

Posted: **Sat Aug 12, 2017 1:44 pm**

nbriley wrote:What is the percentage of infections with an implant and if it does happen what is the treatment? Antibiotics prescribed, the last urologist I saw said my double transplant would not pose a problem other than I may heal slower, any surgery in the past I've healed ok and when I did get an infection I was prescribed Cipro or Kflex
Just wondering.....

I went into septic shock and damn near died one month after implant. Infection probably started at week 3 and just kept getting worse. I lost my implant and have to wait 6 months before attempting re-implant.

Larry

Posted: **Sat Aug 12, 2017 2:19 pm**

Before going septic were you taking antibiotics

Posted: **Sun Aug 13, 2017 6:25 am**

nbriley wrote:Before going septic were you taking antibiotics

Yes, IV antibiotics during and immediately following surgery and a pill prescription to take home. I never noticed the sepsis coming on because I was quite swollen and everyone just attributed the swelling to the surgery. As for fever, one day I would have a low grade fever, the next it was normal. The day before the surgery it jumped and stayed there. As for pain, I take a lot of pain meds for my back injury as the result of being a paramedic for 15 years and lifting all the time. I was also given prescriptions for Percocets and Dilauded following implant surgery. I was too wasted to know if I was in pain.... but I don't think so.

Larry

Posted: **Thu Aug 17, 2017 9:17 pm**

I did some research on the issue of infection, and I found a nice paper on this .

Impact of Surgeon Case Volume on Reoperation Rates after Inflatable Penile Prosthesis Surgery
Ifeanyi C. Onyeji, et al. From the Department of Urology, Columbia University Medical Center

Shown below is part of the abstract from the paper:

Dr Ifeyani , et al state:
Purpose: We investigated the impact of surgeon annual case volume on reoperation rates after inflatable penile prosthesis surgery.

Methods: The New York Statewide Research Cooperative System database was queried for inflatable penile prosthesis cases from 1995 to 2014.

Results: A total of 14,969 men underwent inflatable penile prosthesis insertion. Median followup was 95.1 months (range 0.5 to 226.7) from the time of implant.
….The rates of overall reoperation, reoperation for infection and reoperation for noninfectious complications were 6.4%, 2.5% and 3.9%, respectively. Implants placed by lower volume implanters were more likely to require reoperation for infection…….

Conclusions: Patients treated by higher volume implanters are less likely to require reoperation after inflatable penile prosthesis insertion than those treated by lower volume surgeons. This trend appears to be driven by associations between surgeon volume and the risk of prosthesis infection.

By the way, here is an interesting statement from the paper regarding infection rates and mechanical failure rates published by other papers:

Dr Ifeanyi reports:
“studies report IPP infection rates of 2% to 5% at 5 years and 1.4% to 7% at 10 years.

Mechanical failure rates are reported in the same studies at:
4% to 10% at 5 years
and
10.3% to 24.0% at 10 years.

In addition, here is a key statement:

Dr Ifeyani writes:
The reoperation rate for infection was 4.2% (217 of 5,200) in the era before the routine use of antibiotic impregnated implants and decreased to 1.5% (126 of 8,209) with the widespread use of antibiotic coated prostheses

and Regarding the importance of having a high volume surgeon:

Dr Ifeanyi writes:
A variety of single center, single surgeon studies have similarly reported better reoperation-free survival for patients treated by high volume im-planters. Operative factors could explain this relationship. Higher volume surgeons work with more experienced operating room personnel, who are presumably less likely to inadvertently contaminate an exposed device, and these teams may be more likely to adhere to stringent procedure protocols that are believed to reduce the risk of IPP infection. Adherence to a set of best practices for infection prophylaxis, such as obtaining a negative preoperative urine culture, has been shown to significantly reduce the risk of IPP infection. Adherence to perioperative antibiotic prophylaxis recommendations and standardization of perioperative antimicrobial therapy might also be better with higher volume surgeons.

So , to summarize the paper, the key statistics to remember are:

#1 antibiotic coating has dropped the infection rate to around 1.5%,
and
#2 mechanical failure rates are between 10% and 24% at ten years.

I hope this helps everyone,

TANGERINE

PS: Dr Ifeanyi defines a high volume implant surgeon as one who does more than 31 per year.

PPS, here is the link to the paper:
http://www.jurology.com/article/S0022-5347(16)31069-2/pdf

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