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 Risk factors for reoperation of inflatable penile prosthesis among an ethnically diverse urban population in a high-volume center

International Journal of Impotence Research volume 37, pages 860–861 (2025)Cite this article

Subjects

We were invited to comment upon the paper, Risk factors for reoperation of inflatable penile prosthesis among an ethnically diverse urban population in a high-volume center. This is a study of 530 first time inflatable penile prosthesis (IPP) patients over a 15-year period at an inner-city hospital in New York City [1]. The patients were characterized as being lower socioeconomic status, multi-ethnic, and with a high presence of comorbidities. Regrettably, many of the subjects were lost to follow-up after one year. The study collects an admirable amount of data and is very well written, but we believe the opinions generated from analysis of the data are flawed because of an unusually high infection rate (5.5%) and surgical dehiscence occurrence (2.3%). We are wary of the conclusions concerning risk factors for device infection in this study given the unusually high infection rate is such an outlier compared to published studies from other high-volume centers [2,3,4,5].

Some of the risk factors predisposing patients to infection delineated in this study run counter to our conventional wisdom derived from the 50-year history of IPP publications. To wit, these are the very suspect risk factors delineated in the paper.

  • Infrapubic incision had a significantly higher infection rate. No other paper in the literature has reported this finding.

  • Estimated blood loss over 25cc was a significant risk factor for infection but the median blood loss of the reoperated patients was only 30cc.

  • HgbA1C of over 7.4 was significant for increased risk of infection but the median HgbA1C of the uninfected patients was very similar at 6.8.

  • Patients with Peyronie’s disease (PD) were at higher risk for infection vs patients without PD.

  • Patients with hypertension were at risk for infection.

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

Fig. 1

References

  1. Hawks-Ladds N, Babar M, Labagnara K, Loloi J, Patel RD, Aalami Harandi A, et al. Risk factors for reoperation of inflatable penile prosthesis among an ethnically diverse urban population in a high-volume center. Int J Impot Res. 2024. https://doi.org/10.1038/s41443-024-00966-8.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Eid JF, Wilson SK, Cleves M, Salem EA. Coated implants and “no touch” surgical technique decreases risk of infection in inflatable penile prosthesis implantation to 0.46%. Urology. 2012;79:1310–5. https://doi.org/10.1016/j.urology.2011.11.076.

    Article  PubMed  Google Scholar 

  3. Carson CC 3rd, Mulcahy JJ, Harsch MR. Long-term infection outcomes after original antibiotic impregnated inflatable penile prosthesis implants: up to 7.7 years of followup. J Urol. 2011;185:614–8. https://doi.org/10.1016/j.juro.2010.09.094.

    Article  PubMed  Google Scholar 

  4. Park SH, Wilson SK, Wen L. Subcoronal incision for inflatable penile prosthesis does not risk glans necrosis. J Urol. 2023;210:678–87. https://doi.org/10.1097/JU.0000000000003619.

    Article  PubMed  Google Scholar 

  5. Bole MDR, Habashy MDE, Yang MDD, Ahmed MBBCHM, Trost MDL, Ziegelmann MDM, et al. Timing and causative organisms associated with modern inflatable penile prosthesis infection: an institutional retrospective. J Sex Med. 2023;20:107–12. https://doi.org/10.1093/jsxmed/qdac001.

    Article  Google Scholar 

  6. Wilson SK, Delk JR 2nd. Inflatable penile implant infection: predisposing factors and treatment suggestions. J Urol. 1995;153:659–61.

    Article  CAS  PubMed  Google Scholar 

  7. Köhler 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. https://doi.org/10.1038/s41443-020-0326-5.

    Article  PubMed  Google Scholar 

  8. Gross MS, Phillips EA, Carrasquillo RJ, Thornton A, Greenfield JM, Levine LA, et al. Multicenter Investigation of the micro-organisms involved in penile prosthesis infection: an analysis of the efficacy of the AUA and EAU guidelines for penile prosthesis prophylaxis. J Sex Med. 2017;14:455–63. https://doi.org/10.1016/j.jsxm.2017.01.007.

    Article  PubMed  Google Scholar 

  9. Zargaroff S, Sharma V, Berhanu D, Pearl JA, Meeks JJ, Dupree JM, et al. National trends in the treatment of penile prosthesis infections by explantation alone vs. immediate salvage and reimplantation. J Sex Med. 2014;11:1078–85. https://doi.org/10.1111/jsm.12446.

    Article  PubMed  Google Scholar 

  10. Wilson SK, Gross MS. Biofilm and penile prosthesis infections in the era of coated implants: 2021 update. Int J Impot Res. 2022;34:411–5. https://doi.org/10.1038/s41443-021-00423-w.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Institute for Urologic Excellence, La Quinta, CA, USA

    Steven K. Wilson

  2. Department of Urology, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA

    Britney L. Atwater & Martin S. Gross

Authors
  1. Steven K. Wilson
    View author publications

    Search author on:PubMed Google Scholar

  2. Britney L. Atwater
    View author publications

    Search author on:PubMed Google Scholar

  3. Martin S. Gross
    View author publications

    Search author on:PubMed Google Scholar

Contributions

All authors (SKW, BLA, MSG) have made substantial contributions to this work. All authors (SKW, BLA, MSG) were involved in the acquisition, analysis, and interpretation of data for the work, and all contributed to drafting the manuscript and revised it critically for important intellectual content including final approval of the version to be published. All authors (SKW, BLA, MSG) agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Steven K. Wilson.

Ethics declarations

Competing interests

SKW is a consultant for International Medical Device, Rigicon, Uramix. MSG is a consultant for Coloplast and MenMD. BLA has no disclosures.

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

Wilson, S.K., Atwater, B.L. & Gross, M.S. Comment on Risk factors for reoperation of inflatable penile prosthesis among an ethnically diverse urban population in a high-volume center. Int J Impot Res 37, 860–861 (2025). https://doi.org/10.1038/s41443-024-00989-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Version of record:

  • Issue date:

  • DOI: https://doi.org/10.1038/s41443-024-00989-1

Search

Advanced search

Quick links