Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Comment
  • Published:

Comment on: Does time of intraoperative exposure to the aerobiome increase microbial growth on inflatable penile prostheses?

International Journal of Impotence Research volume 37, page 96 (2025) Cite this article

Subjects

Fortunately, infection associated with a penile prosthesis is rare, but can be a devastating event associated with removal of the device [1]. Studies to elucidate the causes of such an occurrence and methods to prevent it have reduced the incidence [2, 3]. Among patient characteristics, diabetes mellitus and immunosuppression appear to have increased risk of penile prosthesis infection [3]. In relation to the process, primary (initial) surgery and penile prostheses coated with an infection-retardant material seem to reduce the risk of infection [3]. In addition to those risk factors, longer surgeries are assumed to increase the risk of infection because of the increased potential for colonization and the subsequent production of biofilms. However, this theory has never been tested in the field of prosthetic urology.

The manuscript of Madhusoodanan et al. [4] demonstrated that swabs for culture from a rear tip extender and reservoir of a Coloplast Titan implant showed no growth of any type of organism when taken at 30-min intervals up to 3 h at ambient operating room conditions. This important information reinforces the fact that efforts to reduce ambient organism exposure in the operation room, such as laminar flow systems and surgical isolation bubbles, which are expensive and cumbersome to use, are unnecessary. Infections associated with urologic prostheses are thought to come from the skin surrounding the incision [5]. In this study, the control group was swab cultures taken from non-prepped scrotal skin obtained from patients about to have a bilateral vasectomy. All such cultures showed microbial growth, most commonly Corynebacterium. This outcome could be expected. A more useful control group or a separate study group might be swab cultures taken at 30-min intervals up to 3 h from prepped scrotal skin adjacent to an incision for penile implant placement, or a scrotal procedure which would be longer lasting. Previous studies have shown that recolonization of skin after surgical prep and incision increases with time [6]. The proposed study might elucidate a timeframe within which a procedure to insert a penile implant should be completed to help minimize the chance of an infection occurring.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on SpringerLink
  • Instant access to the full article PDF.

USD 39.95

Prices may be subject to local taxes which are calculated during checkout

References

  1. Rezaee ME, Swanton AR, Gross MS, Munarriz RM. A multicenter investigation examining timing of penile prosthesis infection management and responsible organisms. Int J Impot Res. 2024;36:214–217. https://doi.org/10.1038/s41443-022-00659-0.

  2. Preto M, Falcone M, Plamadeala N, Schifano N, Bettocchi C, Colombo F, et al. Risk of unfavorable outcomes after penile prosthesis implantation - results from a national registry (INSIST-ED). Int J Impot Res. 2023. https://doi.org/10.1038/s41443-023-00784-4.

  3. Carvajal A, Benavides J, Garcia-Perdomo HA, Henry GD. Risk factors associated with penile prosthesis infection: systematic review and meta-analysis. Int J Impot Res. 2020;32:587–97.

    Article  PubMed  Google Scholar 

  4. Madhusoodanan VSM, Evans A, Raymo A, Ghomeshi A, Hernandez B, Towe M, et al. Does time of intraoperative exposure to the aerobiome increase microbial growth on inflatable penile prostheses? Int J Impot Res. 2024. https://doi.org/10.1038/s41443-024-00906-6.

  5. Kohler TS, Wen L, Wilson SK. Penile implant infection prevention part 1: what is fact and what is fiction? Wilson’s Workshop #9. Int J Impot Res. 2020;33:785–92.

    Article  PubMed  Google Scholar 

  6. Rouquette L, Traore O, Descamps S, Boisgard S, Villatte G, Erivan R. Bacterial skin recolonization in the operating room: comparison between various antisepsis protocols. J Hosp Infect. 2020;106:57–64.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Mulcahy Consulting, Inc., Surgery, Madison, AL, USA

    John J. Mulcahy

Authors
  1. John J. Mulcahy
    View author publications

    Search author on:PubMed Google Scholar

Contributions

All contributions were from the single author.

Corresponding author

Correspondence to John J. Mulcahy.

Ethics declarations

Competing interests

The author declares no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mulcahy, J.J. Comment on: Does time of intraoperative exposure to the aerobiome increase microbial growth on inflatable penile prostheses?. Int J Impot Res 37, 96 (2025). https://doi.org/10.1038/s41443-024-00907-5

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Version of record:

  • Issue date:

  • DOI: https://doi.org/10.1038/s41443-024-00907-5

This article is cited by

Search

Advanced search

Quick links