Infections lower at high-volume penile-implant centers

Men who receive inflatable penile prostheses at hospitals that perform a higher number of these procedures experience fewer postoperative infections than those treated at lower-volume hospitals, according to a study published in the journal Urology. 

Researchers analyzed data from more than 18,000 U.S. men who underwent first-time penile implant surgery between 2016 and 2022. The study examined whether hospital and surgeon experience — measured by the number of these procedures performed — was linked to rates of infection following surgery. 

Infection rates were significantly lower at high-volume hospitals (2.4%) compared with low-volume hospitals (3.7%), the researchers found.    

“These results highlight the importance of surgical experience and hospital resources in achieving better outcomes,” the authors wrote.  

This observation applies not only to the surgeons, but to the entire team.  

“This would include everyone involved in the patient’s care pathway, including circulating nurses and scrub technicians in the operating room, and postoperative care team,” said the lead author, UW Medicine urologist Dr. Vi Nguyen.  

Inflatable penile prosthesis implantation is a common treatment for severe erectile dysfunction when medications and other therapies fail. It is an operation that focuses on restoring male sexual function rather than cosmetic considerations, Nguyen stressed. 

Infections, while uncommon, can require device removal and revision surgery. This surgery is often done on cancer survivors who are recovering from prostate, bladder, or colorectal cancers. 

“They are so grateful the cancer is gone, but it doesn’t mean we can’t improve their quality of life,” Nguyen said 

Surgeons who perform more than 33 such procedures in a year are considered high volume practitioners, the authors noted. High volume hospitals should have over 60 such procedures in a year.  

The authors suggest that referring patients to higher-volume centers or implementing standardized infection-prevention protocols across all facilities, could improve outcomes nationwide. 

Penile prostheses involve implantation of cylinders within the penis. A small pump is placed in the scrotum. A fluid reservoir is placed in the lower abdomen. When the patient squeezes the pump, fluid moves from the reservoir into the cylinders and creates an erection. Pressing a deflation button returns the fluid to the reservoir.  

Funding for this study came from Boston Scientific.  

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