(278) THE USE OF IRRISEPT AT THE TIME OF IMPLANTATION OF INFLATABLE PENILE PROSTHESES REDUCES CULTURE POSITIVITY AT THE TIME OF REMOVAL AND REPLACEMENT SURGERY FOR NON-INFECTED IMPLANTS

Abstract Introduction The inflatable penile prosthesis provides durable management for erectile dysfunction with high rates of patient satisfaction; however, the device is still limited by a mechanical lifespan and the risk of infection. Multiple studies have examined the presence of biofilm at the time of revision surgery with reported rates of positivity being as high as 80%. The advent of antiseptic irrigation, notably Irrisept™ (0.05% chlorhexidine gluconate), has potentially introduced a paradigm shift that may alter the rate of culture positivity during revision surgery. Objective To evaluate the antibiogram of organisms isolated during penile prosthesis revision surgery before and after the implementation of Irrisept™ irrigation during the device’s original implantation. Methods Data was collected using our institution’s prospectively managed database of penile prosthesis surgery. All 845 penile prosthesis cases from the start of Irrisept use in November 2019 to January 2024 were reviewed. Of the 194 removal and replacement cases for non-infectious indications, operative details from the initial implantation and culture data from the time of revision were available for 72 cases. Of these, 22 had undergone original implantation with use of Irrisept irrigation and 50 were performed without Irrisept use at the time of original implantation. Results The patient demographics before and after the use of Irrisept were similar, with average ages being 69 and 65 in the pre and post-Irrisept cohorts, respectively. A higher proportion of patients in the pre-Irrisept cohort did have devices with Inhibizone (54% versus 32%) and increased rates of diabetes (36% versus 32%); however, tobacco use was higher in the post-Irrisept™ population (50% versus 38%). Notably, the percent of cases with positive swab cultures at the time of removal and replacement were 9% in the post-Irrisept group compared to 22% in cases where Irrisept™ was not used. Conclusions The use of Irrisept™ antiseptic irrigation at the time of implantation is associated with a decreased rate of culture positivity at the time of removal and replacement for non-infected inflatable penile prostheses. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Boston Scientific and Coloplast.