197 Purulent Inflatable Penile Prostheses Can be Safely Immediately Salvaged in Insulin-Dependent Type II Diabetics

Abstract

Historically, contraindications for immediate salvage of an infected penile prosthesis included purulence on the device, purulent infections in diabetic patients, severe diabetes, and immunosuppression. These clinical principles are from the 1990s-early 2000s and based on limited retrospective series or expert opinion. Since the publication of these contraindications there have been improvements in device design, surgical technique, corporal washout protocols, and perioperative antibiotic prophylaxis that allow us to challenge past dogma and reevaluate whether we can broaden the criteria for immediate salvage of an infected penile prosthesis. “Severe diabetes” has never been formally defined in the endocrinology or urologic prosthetic literature. We considered a “severe diabetic” as a patient whose disease has progressed past diet control and oral medications to have IDDM II. Additionally, Orthopedics’ prosthetic literature has noted those with IDDM II who undergo total knee arthroplasty to have worse outcomes than both non-insulin-dependent diabetics and non-diabetics (1, 2).