PD20-06 PROSPECTIVE ANALYSIS OF CULTURES FROM THE FURLOW INSERTION TOOL: A POSSIBLE ETIOLOGY FOR PENILE PROSTHESIS INFECTIONS

You have accessJournal of UrologySexual Function/Dysfunction: Surgical Therapy I (PD20)1 Apr 2020PD20-06 PROSPECTIVE ANALYSIS OF CULTURES FROM THE FURLOW INSERTION TOOL: A POSSIBLE ETIOLOGY FOR PENILE PROSTHESIS INFECTIONS Faysal A. Yafi*, Georgios Hatzichristodoulou, James Furr, Farouk M. El-Khatib, Luca Venturino, Robert Andrianne, Daniar Osmonov, David Ralph, Javier Romero Otero, Maxime Sempels, Koenraad van Renterghem, Aaron Lentz, and Steven K. Wilson Faysal A. Yafi*Faysal A. Yafi* More articles by this author , Georgios HatzichristodoulouGeorgios Hatzichristodoulou More articles by this author , James FurrJames Furr More articles by this author , Farouk M. El-KhatibFarouk M. El-Khatib More articles by this author , Luca VenturinoLuca Venturino More articles by this author , Robert AndrianneRobert Andrianne More articles by this author , Daniar OsmonovDaniar Osmonov More articles by this author , David RalphDavid Ralph More articles by this author , Javier Romero OteroJavier Romero Otero More articles by this author , Maxime SempelsMaxime Sempels More articles by this author , Koenraad van RenterghemKoenraad van Renterghem More articles by this author , Aaron LentzAaron Lentz More articles by this author , and Steven K. WilsonSteven K. Wilson More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000870.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The most dreaded complication of penile prosthesis (PP) implantation is device infection. Infection retardant coatings, changes in prep solutions and enhancement of surgical technique have successfully decreased the infection rates in high volume surgeons to <1% in primary implantations and 2-5% in diabetic patients. We sought to assess whether inadequate cleaning and sterilization of the reusable Furlow inserter may represent one of the last etiologies of infection in PP patients. METHODS: We performed a prospective analysis of cultures of the Furlow Inserter used for PP surgeries from 7 centers between May 1st and June 30th, 2019. Once the Furlow was received for surgery, the surgical team inspected the device for assembly status (disassembled or not) and the presence of visible stains, pieces of tissue or discoloration on either the interior of the barrel or the plunger. Swab aerobic and anaerobic bacterial and fungal cultures were then obtained from the internal component, after removal from the external component if assembled, and after introduction and immediate removal from the external component if disassembled. RESULTS: A total of 83 Furlow devices were cultured. Median age of surgical instrument was 4 years (2-10 years). Methods of sterilization included autoclave, wet autoclave, steam and Sterrad. Median time from sterilization was 3 days (1-22). On initial presentation, 79 devices were disassembled (95.1%) and 4 devices were still assembled (4.9%). Three external components were discolored (3.6%), while internal components demonstrated 2 stains (2.4%) indicative of improper cleaning which were thought to be residual blood products. Overall, 2/83 (2.4%) devices revealed positive swab cultures for Staphylococcus Epidermidis. Swab cultures were negative for fungi and anaerobic bacteria. This patient cohort will continue to be followed to see if device infection occurs but it is unlikely to be meaningful since contaminated Furlows were discarded. CONCLUSIONS: Improper cleaning and/or sterilization of the Furlow Insertion Instrument may represent a source of infection for patients undergoing PP implantation. Source of Funding: none © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e449-e449 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Faysal A. Yafi* More articles by this author Georgios Hatzichristodoulou More articles by this author James Furr More articles by this author Farouk M. El-Khatib More articles by this author Luca Venturino More articles by this author Robert Andrianne More articles by this author Daniar Osmonov More articles by this author David Ralph More articles by this author Javier Romero Otero More articles by this author Maxime Sempels More articles by this author Koenraad van Renterghem More articles by this author Aaron Lentz More articles by this author Steven K. Wilson More articles by this author Expand All Advertisement PDF downloadLoading ...