{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T06:17:48Z","timestamp":1790662668487,"version":"4.1.0"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2019,7,1]],"date-time":"2019-07-01T00:00:00Z","timestamp":1561939200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"},{"start":{"date-parts":[[2019,7,1]],"date-time":"2019-07-01T00:00:00Z","timestamp":1561939200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"content-domain":{"domain":["jsm.jsexmed.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Fungal infections of inflatable penile prostheses (IPPs) are inadequately understood in the literature.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aim<\/jats:title>\n                  <jats:p>To review a multi-institution database of IPP infections to examine for common patient and surgical factors related to IPP fungal infections.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This is a retrospective Institutional Review Board\u2013approved analysis of 217 patients at 26 institutions who underwent salvage or device explant between 2001 and 2018. Patient data were compiled after an extensive record review.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Outcomes<\/jats:title>\n                  <jats:p>26 patients (12%) with fungal infections were identified.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>23 of 26 patients (83%) with a fungal IPP infection were either diabetic or overweight. 15 patients had undergone primary IPP implantation, and the other 11 had previously undergone an average of 1.7 IPP-related surgeries (range 1\u20133; median 2). The average age at implantation was 63 years (range 31\u201392; median 63). 18 of the 26 patients with fungal infection had diabetes (69%), with a mean hemoglobin A1c (HbA1c) value of 8.4 (range 5.8\u201313.3; median 7.5). Twenty-two patients (85%) were overweight or obese. The mean body mass index for all patients was 30.1 kg\/m2 (range 23.7\u201345 kg\/m2; median 28.4 kg\/m2), and that for diabetic patients was 30.8 kg\/m2 (range 24.1\u201345 kg\/m2, median 29.7 kg\/m2). Ninety-one percent of implants were placed with intravenous antibiotics, consistent with current American Urological Association guidelines: an aminoglycoside plus first- or second-generation cephalosporin or vancomycin or ampicillin\/sulbactam or piperacillin\/tazobactam. 65% (17 of 26) of infected IPPs had only fungal growth in culture. No patient had concomitant immunosuppressive disease or recent antibiotic exposure before IPP implantation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical Implications<\/jats:title>\n                  <jats:p>More than two-thirds of the fungal infections occurred in diabetic patients and 85% occurred in overweight or obese patients, suggesting that antifungal prophylaxis may be appropriate in these patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Strengths &amp; Limitations<\/jats:title>\n                  <jats:p>This is the largest series of fungal infections reported to date in the penile prosthesis literature. The overall number of such cases, however, remains small.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Fungal infections represent 12% of all penile prosthesis infections in our series and were seen mostly in diabetic or overweight patients, who may benefit from antifungal prophylaxis.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1016\/j.jsxm.2019.05.003","type":"journal-article","created":{"date-parts":[[2019,6,26]],"date-time":"2019-06-26T11:13:00Z","timestamp":1561547580000},"page":"1100-1105","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":27,"title":["Multicenter Investigation of Fungal Infections of Inflatable Penile Prostheses"],"prefix":"10.1093","volume":"16","author":[{"given":"Martin S.","family":"Gross","sequence":"first","affiliation":[{"name":"Section of Urology , Lebanon, NH , USA"},{"name":"Dartmouth Hitchcock Medical Center , Lebanon, NH , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lael","family":"Reinstatler","sequence":"additional","affiliation":[{"name":"Section of Urology , Lebanon, NH , USA"},{"name":"Dartmouth Hitchcock Medical Center , Lebanon, NH , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerard D.","family":"Henry","sequence":"additional","affiliation":[{"name":"Ark-La-Tex Urology , Bossier City, LA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stanton C.","family":"Honig","sequence":"additional","affiliation":[{"name":"Department of Urology , New Haven, CT , USA"},{"name":"Yale School of Medicine , New Haven, CT , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter J.","family":"Stahl","sequence":"additional","affiliation":[{"name":"Department of Urology , New York, NY , USA"},{"name":"Columbia University College of Physicians & Surgeons , New York, NY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arthur L.","family":"Burnett","sequence":"additional","affiliation":[{"name":"Department of Urology , Baltimore, MD , USA"},{"name":"Johns Hopkins University School of Medicine , Baltimore, MD , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro P.","family":"Maria","sequence":"additional","affiliation":[{"name":"Department of Urology , Bronx, NY , USA"},{"name":"Albert Einstein College of Medicine , Bronx, NY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nelson E.","family":"Bennett","sequence":"additional","affiliation":[{"name":"Department of Urology , Chicago, IL , USA"},{"name":"Northwestern University Feinberg School of Medicine , Chicago, IL , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce R.","family":"Kava","sequence":"additional","affiliation":[{"name":"Department of Urology , Miami, FL , USA"},{"name":"University of Miami Miller School of Medicine , Miami, FL , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias S.","family":"Kohler","sequence":"additional","affiliation":[{"name":"Department of Urology , Rochester, MN , USA"},{"name":"Mayo Clinic , Rochester, MN , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan A.","family":"Beilan","sequence":"additional","affiliation":[{"name":"Scott Department of Urology , Houston, TX , USA"},{"name":"Baylor College of Medicine , Houston, TX , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael E.","family":"Carrion","sequence":"additional","affiliation":[{"name":"Department of Urology , Tampa, FL , USA"},{"name":"University of South Florida Morsani College of Medicine , Tampa, FL , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo M.","family":"Munarriz","sequence":"additional","affiliation":[{"name":"Department of Urology , Boston, MA , USA"},{"name":"Boston University Medical Center , Boston, MA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,7,1]]},"reference":[{"key":"2023012309432472500_bib1","first-page":"1705","article-title":"Perioperative prevention of penile prosthesis infection: Practice patterns among surgeons of SMSNA and ISSM","volume":"9","author":"Katz","year":"2012","journal-title":"J\u00a0Sex Med"},{"key":"2023012309432472500_bib2","first-page":"5","article-title":"No-touch technique","volume":"8","author":"Eid","year":"2011","journal-title":"J\u00a0Sex Med"},{"key":"2023012309432472500_bib3","first-page":"619","article-title":"The Henry mummy wrap and the Henry finger sweep surgical techniques","volume":"6","author":"Henry","year":"2009","journal-title":"J\u00a0Sex Med"},{"key":"2023012309432472500_bib4","first-page":"1379","article-title":"Best practice policy statement on urologic surgery antimicrobial prophylaxis","volume":"179","author":"Wolf","year":"2008","journal-title":"J\u00a0Urol"},{"key":"2023012309432472500_bib5","article-title":"Guidelines on urological infections. European Association of Urology 2015","author":"Grabe"},{"key":"2023012309432472500_bib6","first-page":"1855","article-title":"Infection retardant-coated inflatable penile prostheses decrease the incidence of infection: A systematic review and meta-analysis","volume":"188","author":"Mandava","year":"2012","journal-title":"J\u00a0Urol"},{"key":"2023012309432472500_bib7","first-page":"2182","article-title":"Long-term revision rate due to infection in hydrophilic-coated inflatable penile prostheses: 11-year follow-up","volume":"9","author":"Serefoglu","year":"2012","journal-title":"J\u00a0Sex Med"},{"key":"2023012309432472500_bib8","first-page":"614","article-title":"Long-term infection outcomes after original antibiotic impregnated inflatable penile prosthesis implants: Up to 7.7 years of follow-up","volume":"185","author":"Carson","year":"2011","journal-title":"J\u00a0Urol"},{"key":"2023012309432472500_bib9","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1016\/j.ucl.2011.02.007","article-title":"Penile prosthesis infection: Approaches to prevention and treatment","volume":"38","author":"Selph","year":"2011","journal-title":"Urol Clin North Am"},{"key":"2023012309432472500_bib10","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1111\/j.1464-410X.2005.05907.x","article-title":"Outcome of penile prosthesis implantation for treating erectile dysfunction: Experience with 504 procedures","volume":"97","author":"Minervini","year":"2006","journal-title":"BJU Int"},{"key":"2023012309432472500_bib11","first-page":"455","article-title":"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","volume":"14","author":"Gross","year":"2017","journal-title":"J\u00a0Sex Med"},{"key":"2023012309432472500_bib12","first-page":"481","article-title":"Long-term experience with salvage of infected penile implants","volume":"163","author":"Mulcahy","year":"2000","journal-title":"J\u00a0Urol"},{"key":"2023012309432472500_bib13","first-page":"402","article-title":"Risk factors for penile prosthetic infection","volume":"156","author":"Jarow","year":"1996","journal-title":"J\u00a0Urol"},{"key":"2023012309432472500_bib14","first-page":"386","article-title":"Use of glycosylated hemoglobin to identify diabetics at high risk for penile periprosthetic infections","volume":"147","author":"Bishop","year":"1992","journal-title":"J\u00a0Urol"},{"key":"2023012309432472500_bib15","first-page":"659","article-title":"Inflatable penile implant infection: Predisposing factors and treatment suggestions","volume":"153","author":"Wilson","year":"1995","journal-title":"J\u00a0Urol"},{"issue":"Suppl 5","key":"2023012309432472500_bib16","doi-asserted-by":"crossref","first-page":"S139","DOI":"10.1038\/sj.ijir.3901091","article-title":"Diagnosis, treatment and prevention of penile prosthesis infection","volume":"15","author":"Carson","year":"2003","journal-title":"Int J Impot Res"},{"key":"2023012309432472500_bib17","first-page":"1541","article-title":"Candida albicans corpora abscess following penile prosthesis placement","volume":"140","author":"Peppas","year":"1988","journal-title":"J\u00a0Urol"},{"key":"2023012309432472500_bib18","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1002\/sm2.86","article-title":"Two fungal infections of inflatable penile prostheses in diabetics","volume":"3","author":"Cotta","year":"2015","journal-title":"Sex Med"},{"key":"2023012309432472500_bib19","doi-asserted-by":"crossref","first-page":"890","DOI":"10.3109\/00365548.2010.498023","article-title":"Candida prosthetic infections: Case series and literature review","volume":"42","author":"Dutronc","year":"2010","journal-title":"Scand J Infect Dis"},{"key":"2023012309432472500_bib20","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1536\/ihj.17-314","article-title":"Combined surgical and medical therapy for Candida prosthetic endocarditis in a patient with repaired tetralogy of Fallot","volume":"59","author":"Kubota","year":"2018","journal-title":"Int Heart J"},{"key":"2023012309432472500_bib21","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1097\/PRS.0000000000003915","article-title":"Microbial evaluation in capsular contracture of breast implants","volume":"141","author":"Galdiero","year":"2018","journal-title":"Plast Reconstr Surg"},{"key":"2023012309432472500_bib22","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1080\/23744235.2016.1219456","article-title":"Candida-induced prosthetic joint infection. A literature review including 72 cases and a case report","volume":"49","author":"Cobo","year":"2017","journal-title":"Infect Dis Lond Engl"},{"key":"2023012309432472500_bib23","first-page":"155","article-title":"The prosthesis salvage operation: Immediate replacement of the infected penile prosthesis","volume":"155","author":"Brant","year":"1996","journal-title":"J\u00a0Urol"},{"key":"2023012309432472500_bib24","first-page":"694","article-title":"The malleable implant salvage technique: Infection outcomes after Mulcahy salvage procedure and replacement of infected inflatable penile prosthesis with malleable prosthesis","volume":"195","author":"Gross","year":"2016","journal-title":"J\u00a0Urol"},{"key":"2023012309432472500_bib25","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/j.eururo.2011.01.046","article-title":"Long-term infection rates in diabetic patients implanted with antibiotic-impregnated versus nonimpregnated inflatable penile prostheses: 7-year outcomes","volume":"60","author":"Mulcahy","year":"2011","journal-title":"Eur Urol"},{"key":"2023012309432472500_bib26","first-page":"1537","article-title":"Quantifying risk of penile prosthesis infection with elevated glycosylated hemoglobin","volume":"159","author":"Wilson","year":"1998","journal-title":"J\u00a0Urol"},{"key":"2023012309432472500_bib27","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1023\/B:UROL.0000020300.23522.49","article-title":"Risk factors for penile prosthetic infection","volume":"35","author":"Cakan","year":"2003","journal-title":"Int Urol Nephrol"},{"key":"2023012309432472500_bib28","doi-asserted-by":"crossref","first-page":"794","DOI":"10.2106\/JBJS.K.00072","article-title":"Patient-related risk factors for periprosthetic joint infection and postoperative mortality following total hip arthroplasty in Medicare patients","volume":"94","author":"Bozic","year":"2012","journal-title":"J\u00a0Bone Joint Surg Am"},{"key":"2023012309432472500_bib29","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1016\/j.ocl.2018.02.010","article-title":"The effect of obesity in shoulder arthroplasty outcomes and complications","volume":"49","author":"De Martino","year":"2018","journal-title":"Orthop Clin North Am"},{"key":"2023012309432472500_bib30","article-title":"Multicenter investigation on the influence of climate in penile prosthesis infection. Int J Impot Res","author":"Gross"},{"key":"2023012309432472500_bib31","first-page":"697","article-title":"Active polysubstance abuse concurrent with surgery as a possible newly identified infection risk factor in inflatable penile prosthesis placement based on a retrospective analysis of health and socioeconomic factors","volume":"13","author":"Balen","year":"2016","journal-title":"J\u00a0Sex Med"},{"key":"2023012309432472500_bib32","doi-asserted-by":"crossref","first-page":"6550","DOI":"10.1128\/AAC.01088-16","article-title":"Effect of obesity on the population pharmacokinetics of fluconazole in critically ill patients","volume":"60","author":"Alobaid","year":"2016","journal-title":"Antimicrob Agents Chemother"}],"container-title":["The Journal of Sexual Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1743609519311701?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1743609519311701?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/jsm\/article-pdf\/16\/7\/1100\/48588730\/jsm_16_7_1100.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jsm\/article-pdf\/16\/7\/1100\/48588730\/jsm_16_7_1100.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,23]],"date-time":"2023-01-23T10:20:12Z","timestamp":1674469212000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jsm\/article\/16\/7\/1100\/6980550"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,7,1]]},"references-count":32,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2019,7,1]]},"published-print":{"date-parts":[[2019,7,1]]}},"URL":"https:\/\/doi.org\/10.1016\/j.jsxm.2019.05.003","relation":{},"ISSN":["1743-6109","1743-6095"],"issn-type":[{"value":"1743-6109","type":"electronic"},{"value":"1743-6095","type":"print"}],"subject":[],"published-other":{"date-parts":[[2019,7]]},"published":{"date-parts":[[2019,7,1]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Multicenter Investigation of Fungal Infections of Inflatable Penile Prostheses","name":"articletitle","label":"Article Title"},{"value":"The Journal of Sexual Medicine","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jsxm.2019.05.003","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2019 International Society for Sexual Medicine. Published by Elsevier Inc.","name":"copyright","label":"Copyright"}]}}