Does surgical approach affect the incidence of inflatable penile prosthesis infection?

Objectives. To review retrospectively the rate of infection in 380 consecutive organically impotent men implanted with a Mentor Alpha I inflatable penile prosthesis, stratified by surgical approach (scrotal or infrapubic). Methods. Data were obtained from review of medical records. One hundred percent of cases were available for a minimum postoperative follow-up of 6 months. Results. Twenty patients had a prior penile prosthetic operation and were excluded, leaving 560 primary implants for review. Overall, 6 patients (1.7%) developed periprosthetic infection. Four of these 6 patients were diabetic. Four of 139 infrapubic cases (2.9%) and 2 of 221 scrotal cases (0.9%) developed periprosthetic infection. This difference was not statistically significant (P = 0.15). Equal proportions of the infrapubic (39.6%) and scrotal cases (40.3%) were diabetic patients. The infection rate in patients with and without diabetes was 4 of 144 (2.8%) and 2 of 216 (0.9%), respectively. This difference was not statistically significant (P = 0.18). Conclusions. This study indicates that there is no statistically significant difference in the infection rate when the scrotal and infrapubic approaches to inflatable penile prosthesis insertion are compared. UROLOGY 52: 291-295, 1998. (C) 1998, Elsevier Science Inc. All rights reserved.