Penile prostheses commonly coated with bacteria

By Will Boggs, MD

NEW YORK (Reuters Health) - An examination of removed penile prostheses shows that, although not infectious disease is present, the devices are often coated with bacteria, according to a report in The Journal of Urology.

"Most implants have in my opinion a minimal amount of bacterial contamination from skin, air, etc., despite the best attempts at total sterility," Dr. Craig F. Donatucci from Duke University Medical Center, Durham, North Carolina told Reuters Health. The combination of low amounts of bacteria and the patient's immune system defenses eliminate or contain the bacteria most of the time.

Donatucci and colleagues investigated the extent of bacterial growth on penile prostheses that were not infected from a clinical standpoint when they were removed for mechanical failure.

Out of 10 prostheses, 8 contained bacteria, the authors report, and 7 of the 10 had a thin layer of living cells, known as a biofilm. Only 2 prostheses had no organisms of any type.

"We thought that biofilm might be present on most if not all prosthetic implants and that the body's defense system would under most circumstances control the contamination so there would be no clinical infection," Donatucci explained.

"Revision surgery was thought to upset that control and lead to infection in the revised prosthesis," he continued.

"Many influences come into play," including the patient's immune status, the presence of other illness, and the bacteria type in the implant, "so while one patient may control the bacteria, another may have a clinical infection with the same number or even less at time of implant," Donatucci said.

SOURCE: Journal of Urology, September 2006.