Malleable Implant Substitution for the Management of Penile Prosthesis Pump Erosion: A Pilot Study

Abstract

Managing isolated scrotal pump erosion or infection in patients with inflatable penile prosthesis (IPP) is a challenging problem. We describe our malleable implant substitution technique to address this problem. The aim of this study was to describe and assess the outcomes of the malleable implant substitution technique. In this retrospective case series, six patients underwent removal of the infected and/or eroded scrotal pump, and replacement of the entire IPP with a malleable prosthesis. This procedure was only performed in men in the absence of penile pain on palpation or overwhelming sepsis. The procedure utilized components of the Mulcahy washout protocol with loose scrotal wound approximation and drains as necessary. The main outcome is a recurrent infection rate and prosthesis functionality of the malleable implant substitution technique. All six men who underwent the procedure have done well and remain infection-free. Two men have undergone conversion from a malleable prosthesis back to IPP. Three are considering conversion to an IPP as they are satisfied with their current malleable prosthesis function. One man had a distal erosion of the malleable prosthesis that necessitated complete removal. We believe the malleable implant substitution technique provides an excellent option for management of isolated scrotal pump erosion or infection and prevents the problems associated with the other common management strategies.