AI Article Synopsis
- The study reviews existing literature on antifungal prophylaxis during penile prosthesis (PP) surgery to evaluate its effectiveness in reducing post-surgery fungal infections.
- A systematic search of databases revealed nine studies showing that fungal infections accounted for 11.1% of all PP infections, with higher risks in patients with diabetes, obesity, and in warmer climates.
- Current guidelines from the American and European urology associations do not include antifungal treatment, but combining antifungals with antibiotics could lower infection rates, suggesting that broader use of antifungal prophylaxis might be beneficial.
Article Abstract
Objective: The aim of this study is to review the literature on the use of antifungal prophylaxis in penile prosthesis (PP) surgery and provide a summary on its efficacy as an adjunct to current prophylactic regimes in patients undergoing PP surgery.
Materials And Methods: PubMed, Medline, and EMBASE databases were systematically searched up to May 2020. All included studies were analysed and the information extracted included author, title of study, year of publication, type of study, journal of publication, and main findings regarding post PP implantation fungal infections.
Results: Nine relevant studies were included in this review, comprising retrospective single-centre studies and retrospective multicentre studies ranging from 2017 to 2020. Fungal infections were found responsible for 11.1% of all PP infections, with a greater risk in patients with diabetes, obesity, and from warmer climates. Current American Urological Association (AUA) and European Association of Urology (EAU) prophylaxis guidelines do not incorporate the use of antifungals. Trials of antifungal prophylaxis regimes combined with antibiotic prophylaxis have demonstrated a reduction in PP fungal infections.
Conclusions: Fungal infections represent a significant proportion of implant infections and therefore antifungal prophylaxis is warranted. Future studies comparing the efficacy of traditional antibiotic prophylaxis as set out by AUA/EAU with novel prophylaxis regimes including the addition of an antifungal may provide more definitive guidance on this issue. Until then antifungal prophylaxis in all patients undergoing PP procedures may provide a significant cost-effect benefit.
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| http://dx.doi.org/10.1159/000522173 | DOI Listing |
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