Coated Implants and ``No Touch{''} Surgical Technique Decreases Risk of Infection in Inflatable Penile Prosthesis Implantation to 0.46\%

OBJECTIVE To explore whether a ``no touch{''} enhancement to the surgical technique of inflatable penile prosthesis (IPPs) implantaion will further decrease infection rates. MATERIALS AND METHODS A single surgeon performed 2347 IPPs between January 2002 and June 2011. Patients receiving each manufacturer's implants were stratified for age and diabetes. Since 2003, infection retardant-coated IPPs were implanted through the standardized penoscrotal approach. Since 2006, the ``no touch{''} enhancement was added to the surgical procedure. Infection rates in the noncoated IPP, coated IPP with standard technique, and coated IPP implanted with ``no touch{''} enhancement were calculated and subjected to statistical analysis. The two company's implants were scrutinized for their individual infection rates in each group. RESULTS Patients in all the groups were similar for age and diabetes. 132 noncoated implants had an infection rate of 5.3\%. In the years 2003-2005, 704 coated devices had a statistically significant improvement in incidence of infection to 2\%. In the years 2006-2010, the ``no touch{''} technique enhanced the standard surgical procedure in 1511 patients. Only 7 infections were seen yielding an infection incidence of 0.46\%. There was no difference in the two manufacturer's infection rates. Differentiation between virgin and revision operation displayed no bias in the infection rate. CONCLUSION Infection-retardant coatings lower the risk of infection from 5.3\% to 2\%. The ``no touch{''} enhancement to the surgical procedure further decreases the rate of infection to 0.46\%. Neither manufacturer showed statistical superiority in survival from revision for infection. UROLOGY 79: 1310-1316, 2012. (C) 2012 Elsevier Inc.