Erectile Dysfunction and Penile Implant:

« The Best Solution for the Worst Situation »

by Daniel Chevallier (MD, PHD, FEBU, FACS-EI)

www.mhisc.chMen’s Health International Surgical Center - Place des Philosophes 18, 1205 Geneva Switzerland

GuidelinesEAU2010

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GuidelinesPatientpreparation

Noactiveinfection:systemic,cutaneous orurinaryhttp://www.auanet.org/education/guidelines/erectile-dysfunction.cfm

InFrance• Clipping DDay(ordepilatory cream D-2)(AvoidRazor)

• Betadine showers :2D-1andD-Day• Antibioprophylaxy :Cefazoline 2G30-60mnbefore incision(slowIV)and1Gif>2hours

• IVAntibiotics :100%• Cefazoline• Vancomycine• Ampicilline• Gentamycine

• Post-optreatment 88%,mean 1week withquinolones

• LocalAntibiotics:100%• Aminosides• Cefazoline• Bacitracine• Rifampicine• Polymixine

• Skinpreparation duration>10mn:66%

USAEU

noevidence within tosupporttheuseofantibiotics beyond the

24-hourperiod

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IPP Follow up

3GOALStoreach

Low InfectionRateLow Mechanical Failure Rate

HighSatisfactionRate

Infection Rate and IPPThe Coated Implants Revolution

• 2001 : Inhibizone (Rifampicine+ Minocycline) 1,61 % à 0,68%

• 2002 : Hydrophilic coating PVP (PolyVinylPyrolidone) 2,07 % à 1,06 %

Infection Rate and IPPThe Coated Implants Revolution

36391IPPInfectionrate4,6%IPPNonCoated (7031)

vsInfectionrate1,4%Coated IPP(29360)

Wich type of mechanical problem ?

Abouassaly J Urol 2006 Vol 176 2471-2473

Penile Implant Satisfaction Data: 85 to 97 %

Hellstrom WJG

ERECTILEDYSFONCTIONandPENILEIMPLANT

« TheBestSolutionfortheWorst Situation »?

YES

IPPplacementis asafe procedureNeed ofExperienced Implants

SurgeonsandCenterofExcellenceAsepsis« challenging procedure »but

alow rateofinfectionAHighrateofsatisfactionandduration

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