MP62-11 IRRISEPT WASHOUT AT THE TIME OF REVISION SURGERY DECREASES TISSUE CULTURE POSITIVITY: SINGLE CENTER EXPERIENCE

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP62-11 IRRISEPT WASHOUT AT THE TIME OF REVISION SURGERY DECREASES TISSUE CULTURE POSITIVITY: SINGLE CENTER EXPERIENCE Alex Fuselier, Chris Smith, Ryan Griggs, Paul H. Chung, Ed Karpman, and Gerard Henry Alex FuselierAlex Fuselier More articles by this author , Chris SmithChris Smith More articles by this author , Ryan GriggsRyan Griggs More articles by this author , Paul H. ChungPaul H. Chung More articles by this author , Ed KarpmanEd Karpman More articles by this author , and Gerard HenryGerard Henry More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003320.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The presence of biofilm, which resists eradication, at the implant site during inflatable penile prosthesis (IPP) replacement surgery for infectious or non-infectious reasons appears to increase infection rates. Irrigation at the time of salvage rescue surgery has been shown to work in patients with clinically infected IPPs. Similarly, washout at the time of non-infectious revision surgery has been shown to lower subsequent infection rates. Positive cultures confirm bacterial presence on IPPs in both the clinically infected and uninfected settings. 0.05% chlorhexidine gluconate (CHG) in sterile water (Irrisept, Irrimax Corporation, Lawrenceville, GA) has been shown to reduce biofilm in the orthopedic literature. More recently, it has been shown to be highly efficacious against IPP bacteria such as E. coli and Pseudomonas that now predominate eroded and infected devices. We investigated capsule tissue cultures before and after dilute chlorhexidine irrigation in a series of patients who underwent revision surgery. METHODS: A total of 44 patients with indwelling IPPs underwent revision surgery for both infectious and noninfectious reasons between May 2021 and September 2022. A section of capsule tissue surrounding the pump sent for culture & gram staining. After implant removal, we performed a washout of all implant spaces with 0.05% chlorhexidine gluconate irrigation, 900cc for noninfectious reasons and 1800cc for infectious reasons. A second tissue culture was obtained adjacent to the prior sample post washout. No other additional antibiotic solutions were utilized for irrigation. All patients received clindamycin, gentamicin, and fluconazole for intravenous prophylaxis. RESULTS: Of the 44 patients, 4 (10%) were with infectious / erosion reasons, 40 (90%) had noninfectious etiologies. 6 (14%) of the 44 patients had evidence of positive bacterial presence prior to washout. 4 of the 4 (100%) patients for infectious / erosion reasons and 2 of the 40 (5%) of the noninfectious etiologies had evidence of bacterial presence prior to washout. All 44 (100%) of these patients had negative cultures after dilute chlorhexidine washout. CONCLUSIONS: Early results of revision washout with 0.05% chlorhexidine gluconate in sterile water solution appears to decrease the bacterial load and potentially sterilize the implant capsule at revision surgery of inflatable penile prostheses for both infectious and noninfectious reasons. Consequently, this may lead to future reduction in postoperative infection rates after IPP revision surgery. Source of Funding: Coloplast © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e865 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alex Fuselier More articles by this author Chris Smith More articles by this author Ryan Griggs More articles by this author Paul H. Chung More articles by this author Ed Karpman More articles by this author Gerard Henry More articles by this author Expand All Advertisement PDF downloadLoading ...