MP88-19 POST-OPERATIVE ANTIBIOTICS AFTER PRIMARY ARTIFICIAL URINARY SPHINCTER PLACEMENT DO NOT REDUCE INFECTION OR EROSION RATES

Abstract

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Male Incontinence: Therapy1 Apr 2015MP88-19 POST-OPERATIVE ANTIBIOTICS AFTER PRIMARY ARTIFICIAL URINARY SPHINCTER PLACEMENT DO NOT REDUCE INFECTION OR EROSION RATES J. Patrick Selph, Michael Belsante, Divya Ajay, Aaron Lentz, George Webster, Ngoc-Bich Le, and Andrew Peterson J. Patrick SelphJ. Patrick Selph More articles by this author , Michael BelsanteMichael Belsante More articles by this author , Divya AjayDivya Ajay More articles by this author , Aaron LentzAaron Lentz More articles by this author , George WebsterGeorge Webster More articles by this author , Ngoc-Bich LeNgoc-Bich Le More articles by this author , and Andrew PetersonAndrew Peterson More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1852AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The AMS 800 artificial urinary sphincter (AUS) is considered the gold standard surgical treatment for post-prostatectomy stress incontinence. Feared complications of placement include infection and erosion, with reported rates of 0.5-10.6% and 2.9-12%, respectively. While no guidelines or data exist to support the practice, one study showed that 94% of surgeons send patients home with oral antibiotics after penile prosthesis placement. We postulate that a similar practice exists after AUS placement. We sought to determine if giving post-operative antibiotics at the time of discharge would reduce infection rates in patients undergoing primary AUS placement. METHODS We retrospectively reviewed all patients undergoing AUS placement from 2007 to 2012 at our institution by three surgeons. Two surgeons routinely gave postoperative antibiotics, while a third did not. We included only patients undergoing primary AUS implantation with an Inhibizone-coated device who developed an infection and/or erosion at any time after placement. Exclusion criteria included revision surgery, prior urethral erosion, or device infection or erosion after urethral instrumentation or trauma. Patient records were assessed for postoperative antibiotic prescriptions and device infection or erosion. Statistical analysis of categorical variables was performed using Fisher's exact test. RESULTS 223 patients met inclusion criteria. 159 patients were given antibiotics at discharge, and 65 received no discharge antibiotics. Mean follow-up of the entire group was 17.1 months. There was no significant difference between the two groups in body mass index, presence of a urethral stent, smoking status, radiation history, or presence of diabetes. 6/159 (3.8%) and 1/64 (1.5%) of the antibiotic group and non-antibiotic group developed an infection and/or erosion, respectively. There was no statistically significant difference in infection and/or erosion rates between antibiotic and non-antibiotic groups (p = 0.67). Of the seven patients who developed a device infection and/or erosion, six had prior radiation therapy. CONCLUSIONS Antibiotics given after primary Inhibizone-coated AUS placement do not appear to reduce infection rates. Given the general concern over increasing resistance to antimicrobials, this study supports the notion that patients undergoing primary Inhibizone-coated AUS placement do not require antibiotics after implantation of the AUS. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e1099 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information J. Patrick Selph More articles by this author Michael Belsante More articles by this author Divya Ajay More articles by this author Aaron Lentz More articles by this author George Webster More articles by this author Ngoc-Bich Le More articles by this author Andrew Peterson More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...