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Isolated Infection of a Decommissioned Penile Prosthesis Reservoir with Actinomyces neuii
923
Isolated Infection of a Decommissioned Penile Prosthesis Reservoir with Actinomyces neuii jsm_2144
923..926
Ryan S. Hsi, MD,* James M. Hotaling, MD, MS,* Elysia S. Spencer, BS,* Paul L. Bollyky, MD, Dphil,† and Thomas J. Walsh, MD, MS* *Department of Urology, University of Washington School of Medicine, Seattle, WA, USA; †Division of Allergy and Infectious Disease, University of Washington School of Medicine, Seattle, WA, USA DOI: 10.1111/j.1743-6109.2010.02144.x
ABSTRACT
Introduction. Inflatable penile prostheses (IPPs) are a well-established and reliable treatment for medication refractory erectile dysfunction. The most serious complication with IPPs is infection, with the reported incidence after primary placement 1% to 3% and after revision surgery 8% to 18%. Aim. The aim of this report is to describe an infected decommissioned IPP reservoir with Actinomyces neuii with successful preservation of a functioning implant. Methods. After 9 years of successful use with an IPP (AMS 700 CX) for Peyronie’s disease and organic erectile dysfunction, a 79-year-old man underwent replacement with an AMS 700 LGX. The decommissioned reservoir was kept in the right prevesical space, and the new reservoir was placed in the left prevesical space. Three months later, he presented with right inguinal pain and swelling. Results. He was found to have an infected right reservoir with A. neuii, sparing his new IPP. After removal of the right reservoir, he had an uneventful recovery and has shown no evidence of infection in the new device. Conclusion. Revision surgery for IPPs carries a higher risk for implant infection. This is the first report of a genitourinary implant infection with A. neuii. Aggressive surgical and medical treatment may allow preservation of the functioning implant, despite gross infection of the decommissioned reservoir. Hsi RS, Hotaling JM, Spencer ES, Bollyky PL, and Walsh TJ. Isolated infection of a decommissioned penile prosthesis reservoir with Actinomyces neuii. J Sex Med 2011;8:923–926. Key Words. Penile Prosthesis; Prosthesis-Related Infections; Actinomyces; Erectile Dysfunction; Postoperative Penile Prosthesis Component Infection
Introduction
T
he inflatable penile prosthesis (IPP) is a wellestablished and frequently utilized treatment available for medically refractory erectile dysfunction. This is attributable to the high patient satisfaction, low postoperative morbidity, and reliable mechanical function [1,2]. While improvements in the IPP design and manufacture over the last several decades have contributed to its safety and reliability, postoperative infection remains the most serious and feared complication. The incidence of infection after primary placement is relatively low at 1% to 3%, with a higher risk in revision surgery at 8% to 18% © 2010 International Society for Sexual Medicine
[3]. In this report, we describe the first known case of an IPP infection with Actinomyces neuii. Clinical Case
A 79-year-old man had his first IPP (AMS 700 CX) placed for Peyronie’s disease and organic erectile dysfunction. The device functioned well for 9 years, and he subsequently underwent replacement with AMS 700 LGX IPP after mechanical failure. Preoperatively, the patient was given intravenous ciprofloxacin. The inflatable prostheses were removed via a penoscrotal approach, and the previously placed reservoir was drained, capped, and left in the right prevesical space. Swab cultures J Sex Med 2011;8:923–926
924
Figure 1 Abdominal CT demonstrating inflammatory changes and fluid around the decommissioned right-sided reservoir.
of the fluid surrounding the device were not taken during this operation. The corpora cavernosa were then irrigated sequentially with 1 L each of the three antibiotic solutions: peroxide plus iodine, kanamycin plus cephazolin, and vancomycin plus gentamicin. The reservoir for the new device was placed in the contralateral (left) prevesical space via the floor of the inguinal canal. The patient recovered uneventfully from the operation and was discharged home with a 2-week course of oral ciprofloxacin. He began use of the device 6 weeks after his operation. The patient presented 3 months after surgery with a 2-day history right inguinal pain and swelling, without fever or dysuria. An abdominal computed tomography (CT) scan demonstrated inflammatory changes and fluid around the decommissioned right-sided reservoir (Figure 1). There was no radiographic evidence of inflammation around the IPP or left reservoir. His serum white blood cell (WBC) level was 12.0 thousand/mL. He was started on broad-spectrum intravenous antibiotic therapy with vancomycin and piperacillin/ tazobactam, and returned to the operating room where he underwent right inguinal exploration and removal of the right penile prosthesis reservoir. A purulent fluid collection was found around the prosthesis tubing, and inflammatory tissue changes were found in the area of the previously placed reservoir. The wound was then copiously irrigated with kanamycin plus cefazolin, followed by vancomycin and gentamicin, and finally with bacitracin. There did not appear to be any communication of the infected site to the functioning prosthesis. The wound was kept open with a Penrose drain and J Sex Med 2011;8:923–926
Hsi et al. dressed with wet-to-dry dressings. The patient was admitted for wound care, intravenous antibiotics, and serial examinations. Gram stain of the operative culture revealed gram-positive rods, and antibiotic therapy was narrowed to vancomycin to treat presumed diphtheriods and/or corynebacterium. He was discharged home with a planned 4-week course of cephalexin. Seven days after his reoperation, the pathogen was identified as A. neuii. Susceptibility testing showed sensitivity to ampicillin (Minimum Inhibitory Concentration [MIC] <0.016 Col/mL), and it was changed to oral amoxicillin/clavulanate. He was referred to our Infectious Disease clinic and was finally placed on oral amoxicillin for a planned 12-month treatment course due to the slowgrowing nature of A. neuii. During follow-up clinic visits, he demonstrated rapid wound healing, and after 4 months of follow-up, he shows no evidence of IPP infection. Discussion
Advancements in the design and manufacture of the IPP over the last 30 years have focused on improving mechanical durability and lowering the risk of prosthetic infection. The AMS 700 series is a primarily silicone device with an outer, antibiotic coating (Inhibizone®) that is designed to elute minocycline and rifampin into the surrounding tissue. While the vast majority of IPPs will never require removal for infection, the rate of culturepositive bacteria in clinically noninfected IPPs has been reported as high as 66% [4]. Staphylococcus epidermidis is the most common bacterial organism isolated from IPPs removed for mechanical failure, followed by related organisms of the Staphylococcal genus [4]. Many bacteria, including staphylococci, form a biofilm layer on the implant after adherence and colonization of the device. It has been postulated that the progression to clinical infection of the IPP occurs when the established biofilm and bacterial load overwhelm the protection from the antibiotic coating [4]. The risk is several times higher during revision surgery, which may be due to a combination of factors, including residual biofilm and bacteria after washout, presence of a tissue capsule preventing antibiotic penetration, and prior scar tissue impairing wound healing [3–5]. Antiseptic lavage washout during revision surgery for noninfected IPPs has been shown to decrease bacterial load in the implant space, which is thought to reduce subsequent infection rates [4].
Penile Prosthesis Reservoir Infection with Actinomyces neuii The sequential application of irrigating solutions has been described as part of a salvage protocol for clinically infected IPPs with a reported success rate of 82% [5]. The seven irrigating solutions applied include kanamycin plus bacitracin, hydrogen peroxide, povidone iodine, betadine, and vancomycin and gentamicin. After the corpora cavernosa are thoroughly irrigated, a new device is placed during the same operation. The washout is thought to work through its mechanical and antiseptic properties. The salvage protocol includes a pressure irrigation step with the vancomycin and gentamicin mixture that may break up the biofilm slime layer. We have also found that using a rubber catheter helps to direct the irrigant into the cylinder space. In our case, we used three antiseptic solutions (peroxide plus iodine, kanamycin plus cefazolin, and vancomycin plus gentamicin for the initial operation, and then kanamycin plus cefazolin, vancomycin and gentamicin, and bacitracin for the revision surgery after mechanical failure). To our knowledge, this is the first reported case of a genitourinary prosthetic infection with A. neuii. The genus Actinomyces contains multiple gram-positive, nonspore-forming, anaerobic, and aerotolerant organisms of variable morphology. Prior to 1994, the Actinomyces species were categorized in the Centers for Disease Control (CDC) group 1 and group 1-like coryneform bacteria. With development with new molecular and biochemical analysis, the group was reclassified as Actinomyces based on 16sRNA. A. neuii is grampositive, predominantly a diphtheroidal bacillus, nitrate-reducing, catalase positive, facultatively anaerobic, and alpha-hemolytic. Isolates are obtained mainly from abscesses, blood cultures, and mixed anaerobic flora [6]. Actinomyces species in humans are normal flora in the oral cavity, upper respiratory, and gastrointestinal (GI) tract. Our patient did not have any recent known dental, skin, respiratory, or urinary tract infection around the time of surgery. Funke et al. reported on 67 patients with A. neuii infections [7]. Thirty patients (45%) presented as axillary, inguinal, mammary abscesses. Sixteen patients (24%) had atheromas, and nine patients (13%) had skin lesions, most of whom were immunocompromised. A. neuii was isolated from ejaculate and urine cultures from two patients (3%) with prostatitis and in another two with urinary tract infections, respectively. There was once case of fatal septicemia in a nonimmunocompromised patient.
925
A. neuii has been implicated in infections with several types of implants, including a mammary prosthesis [8], ventriculoperitoneal shunt [9], and prosthetic valve causing endocarditis [10]. Treatment included broad-spectrum intravenous antibiotics followed by narrowing to intravenous penicillin G or amoxicillin when culture sensitivities were known. The management of the infected hardware varied in each case. The infected ventriculoperitoneal shunt was removed and replaced with a temporary ventriculostomy drain. Twelve days later, a new ventriculoperitoneal drain was placed [9]. The infected prosthetic heart valve was treated with antibiotics without the removal of the valve [10]. During revision surgery for mechanical failure, the reservoir is routinely decommissioned and left in the prevesical space to prevent the morbidity of removal. Rajpurkar et al. evaluated the safety of retaining the decommissioned reservoir during replacement of an IPP for mechanical failure in 85 patients. Infection developed in one patient, and no patient had reservoir erosion into the bladder or bowel. The authors concluded that routine removal of reservoirs is not necessary [11]. In this case, infection appeared to be isolated to the decommissioned reservoir and the new IPP did not need to be removed. Now, after 4 months of follow-up, there is no evidence of infection of the new IPP, suggesting that preservation of the device is feasible in this unique clinical situation. A word of caution: Had the patient demonstrated any clinical evidence of infection in the current IPP or should the patient demonstrate evidence of this in the future, a more aggressive treatment course would have been or will be pursued with either a salvage operation or a simple device removal. Corresponding Author: Thomas J. Walsh, MD, MS, Department of Urology, University of Washington School of Medicine, 1959 NE Pacific Street, Box 356510, Seattle, WA 98195, USA. Tel: 206-543-3533; Fax: 206-543-3272; E-mail: [email protected] Conflict of Interest: TJ Walsh is a consultant for American Medical Systems. Statement of Authorship
Category 1 (a) Conception and Design Paul L. Bollyky; Thomas J. Walsh (b) Acquisition of Data Paul L. Bollyky; Thomas J. Walsh (c) Analysis and Interpretation of Data James M. Hotaling; Ryan S. Hsi; Thomas J. Walsh J Sex Med 2011;8:923–926
926
Category 2 (a) Drafting the Article Elysia S. Spencer; Ryan S. Hsi; James M. Hotaling (b) Revising it for Intellectual Content James M. Hotaling; Thomas J. Walsh; Ryan S. Hsi
Category 3 (a) Final Approval of the Completed Article Elysia S. Spencer; Ryan S. Hsi; James M. Hotaling; Thomas J. Walsh; Paul L. Bollyky
References 1 Carson CC, Mulcahy JJ, Govier FE. Efficacy, safety and patient satisfaction outcomes of the AMS 700CX inflatable penile prosthesis: Results of a long-term multicenter study. AMS 700CX Study Group. J Urol 2000;164:376–80. 2 Levine LA, Benson J, Hoover C. Inflatable penile prosthesis placement in men with Peyronie’s disease and drug-resistant erectile dysfunction: A single-center study. J Sex Med 2010; 7:3775–83. 3 Wilson SK, Delk JR 2nd. Inflatable penile implant infection: Predisposing factors and treatment suggestions. J Urol 1995; 153:659–61.
J Sex Med 2011;8:923–926
Hsi et al. 4 Henry GD, Carson CC, Wilson SK, Wiygul J, Tornehl C, Cleves MA, Simmons CJ, Donatucci CF. Revision washout decreases implant capsule tissue culture positivity: A multicenter study. J Urol 2008;179:186–90; discussion 90. 5 Mulcahy JJ. Long-term experience with salvage of infected penile implants. J Urol 2000;163:481–2. 6 Funke G, Stubbs S, von Graevenitz A, Collins MD. Assignment of human-derived CDC group 1 coryneform bacteria and CDC group 1-like coryneform bacteria to the genus Actinomyces as Actinomyces neuii subsp. neuii sp. nov., subsp. nov., and Actinomyces neuii subsp. anitratus subsp. nov. Int J Syst Bacteriol 1994;44:167–71. 7 Funke G, von Graevenitz A. Infections due to Actinomyces neuii (former “CDC coryneform group 1” bacteria). Infection 1995;23:73–5. 8 Brunner S, Graf S, Riegel P, Altwegg M. Catalase-negative Actinomyces neuii subsp. neuii isolated from an infected mammary prosthesis. Int J Med Microbiol 2000;290:285–7. 9 Watkins RR, Anthony K, Schroder S, Hall GS. Ventriculoperitoneal shunt infection caused by Actinomyces neuii subsp. neuii. J Clin Microbiol 2008;46:1888–9. 10 Grundmann S, Huebner J, Stuplich J, Koch A, Wu K, GeibelZehender A, Bode C, Brunner M. Prosthetic valve endocarditis due to Actinomyces neuii successfully treated with antibiotic therapy. J Clin Microbiol 2010;48:1008–11. 11 Rajpurkar A, Bianco FF Jr, Al-Omar O, Terlecki R, Dhabuwala C. Fate of the retained reservoir after replacement of 3-piece penile prosthesis. J Urol 2004;172:664–6.
Isolated Infection of a Decommissioned Penile Prosthesis Reservoir with Actinomyces neuii jsm_2144
923..926
Ryan S. Hsi, MD,* James M. Hotaling, MD, MS,* Elysia S. Spencer, BS,* Paul L. Bollyky, MD, Dphil,† and Thomas J. Walsh, MD, MS* *Department of Urology, University of Washington School of Medicine, Seattle, WA, USA; †Division of Allergy and Infectious Disease, University of Washington School of Medicine, Seattle, WA, USA DOI: 10.1111/j.1743-6109.2010.02144.x
ABSTRACT
Introduction. Inflatable penile prostheses (IPPs) are a well-established and reliable treatment for medication refractory erectile dysfunction. The most serious complication with IPPs is infection, with the reported incidence after primary placement 1% to 3% and after revision surgery 8% to 18%. Aim. The aim of this report is to describe an infected decommissioned IPP reservoir with Actinomyces neuii with successful preservation of a functioning implant. Methods. After 9 years of successful use with an IPP (AMS 700 CX) for Peyronie’s disease and organic erectile dysfunction, a 79-year-old man underwent replacement with an AMS 700 LGX. The decommissioned reservoir was kept in the right prevesical space, and the new reservoir was placed in the left prevesical space. Three months later, he presented with right inguinal pain and swelling. Results. He was found to have an infected right reservoir with A. neuii, sparing his new IPP. After removal of the right reservoir, he had an uneventful recovery and has shown no evidence of infection in the new device. Conclusion. Revision surgery for IPPs carries a higher risk for implant infection. This is the first report of a genitourinary implant infection with A. neuii. Aggressive surgical and medical treatment may allow preservation of the functioning implant, despite gross infection of the decommissioned reservoir. Hsi RS, Hotaling JM, Spencer ES, Bollyky PL, and Walsh TJ. Isolated infection of a decommissioned penile prosthesis reservoir with Actinomyces neuii. J Sex Med 2011;8:923–926. Key Words. Penile Prosthesis; Prosthesis-Related Infections; Actinomyces; Erectile Dysfunction; Postoperative Penile Prosthesis Component Infection
Introduction
T
he inflatable penile prosthesis (IPP) is a wellestablished and frequently utilized treatment available for medically refractory erectile dysfunction. This is attributable to the high patient satisfaction, low postoperative morbidity, and reliable mechanical function [1,2]. While improvements in the IPP design and manufacture over the last several decades have contributed to its safety and reliability, postoperative infection remains the most serious and feared complication. The incidence of infection after primary placement is relatively low at 1% to 3%, with a higher risk in revision surgery at 8% to 18% © 2010 International Society for Sexual Medicine
[3]. In this report, we describe the first known case of an IPP infection with Actinomyces neuii. Clinical Case
A 79-year-old man had his first IPP (AMS 700 CX) placed for Peyronie’s disease and organic erectile dysfunction. The device functioned well for 9 years, and he subsequently underwent replacement with AMS 700 LGX IPP after mechanical failure. Preoperatively, the patient was given intravenous ciprofloxacin. The inflatable prostheses were removed via a penoscrotal approach, and the previously placed reservoir was drained, capped, and left in the right prevesical space. Swab cultures J Sex Med 2011;8:923–926
924
Figure 1 Abdominal CT demonstrating inflammatory changes and fluid around the decommissioned right-sided reservoir.
of the fluid surrounding the device were not taken during this operation. The corpora cavernosa were then irrigated sequentially with 1 L each of the three antibiotic solutions: peroxide plus iodine, kanamycin plus cephazolin, and vancomycin plus gentamicin. The reservoir for the new device was placed in the contralateral (left) prevesical space via the floor of the inguinal canal. The patient recovered uneventfully from the operation and was discharged home with a 2-week course of oral ciprofloxacin. He began use of the device 6 weeks after his operation. The patient presented 3 months after surgery with a 2-day history right inguinal pain and swelling, without fever or dysuria. An abdominal computed tomography (CT) scan demonstrated inflammatory changes and fluid around the decommissioned right-sided reservoir (Figure 1). There was no radiographic evidence of inflammation around the IPP or left reservoir. His serum white blood cell (WBC) level was 12.0 thousand/mL. He was started on broad-spectrum intravenous antibiotic therapy with vancomycin and piperacillin/ tazobactam, and returned to the operating room where he underwent right inguinal exploration and removal of the right penile prosthesis reservoir. A purulent fluid collection was found around the prosthesis tubing, and inflammatory tissue changes were found in the area of the previously placed reservoir. The wound was then copiously irrigated with kanamycin plus cefazolin, followed by vancomycin and gentamicin, and finally with bacitracin. There did not appear to be any communication of the infected site to the functioning prosthesis. The wound was kept open with a Penrose drain and J Sex Med 2011;8:923–926
Hsi et al. dressed with wet-to-dry dressings. The patient was admitted for wound care, intravenous antibiotics, and serial examinations. Gram stain of the operative culture revealed gram-positive rods, and antibiotic therapy was narrowed to vancomycin to treat presumed diphtheriods and/or corynebacterium. He was discharged home with a planned 4-week course of cephalexin. Seven days after his reoperation, the pathogen was identified as A. neuii. Susceptibility testing showed sensitivity to ampicillin (Minimum Inhibitory Concentration [MIC] <0.016 Col/mL), and it was changed to oral amoxicillin/clavulanate. He was referred to our Infectious Disease clinic and was finally placed on oral amoxicillin for a planned 12-month treatment course due to the slowgrowing nature of A. neuii. During follow-up clinic visits, he demonstrated rapid wound healing, and after 4 months of follow-up, he shows no evidence of IPP infection. Discussion
Advancements in the design and manufacture of the IPP over the last 30 years have focused on improving mechanical durability and lowering the risk of prosthetic infection. The AMS 700 series is a primarily silicone device with an outer, antibiotic coating (Inhibizone®) that is designed to elute minocycline and rifampin into the surrounding tissue. While the vast majority of IPPs will never require removal for infection, the rate of culturepositive bacteria in clinically noninfected IPPs has been reported as high as 66% [4]. Staphylococcus epidermidis is the most common bacterial organism isolated from IPPs removed for mechanical failure, followed by related organisms of the Staphylococcal genus [4]. Many bacteria, including staphylococci, form a biofilm layer on the implant after adherence and colonization of the device. It has been postulated that the progression to clinical infection of the IPP occurs when the established biofilm and bacterial load overwhelm the protection from the antibiotic coating [4]. The risk is several times higher during revision surgery, which may be due to a combination of factors, including residual biofilm and bacteria after washout, presence of a tissue capsule preventing antibiotic penetration, and prior scar tissue impairing wound healing [3–5]. Antiseptic lavage washout during revision surgery for noninfected IPPs has been shown to decrease bacterial load in the implant space, which is thought to reduce subsequent infection rates [4].
Penile Prosthesis Reservoir Infection with Actinomyces neuii The sequential application of irrigating solutions has been described as part of a salvage protocol for clinically infected IPPs with a reported success rate of 82% [5]. The seven irrigating solutions applied include kanamycin plus bacitracin, hydrogen peroxide, povidone iodine, betadine, and vancomycin and gentamicin. After the corpora cavernosa are thoroughly irrigated, a new device is placed during the same operation. The washout is thought to work through its mechanical and antiseptic properties. The salvage protocol includes a pressure irrigation step with the vancomycin and gentamicin mixture that may break up the biofilm slime layer. We have also found that using a rubber catheter helps to direct the irrigant into the cylinder space. In our case, we used three antiseptic solutions (peroxide plus iodine, kanamycin plus cefazolin, and vancomycin plus gentamicin for the initial operation, and then kanamycin plus cefazolin, vancomycin and gentamicin, and bacitracin for the revision surgery after mechanical failure). To our knowledge, this is the first reported case of a genitourinary prosthetic infection with A. neuii. The genus Actinomyces contains multiple gram-positive, nonspore-forming, anaerobic, and aerotolerant organisms of variable morphology. Prior to 1994, the Actinomyces species were categorized in the Centers for Disease Control (CDC) group 1 and group 1-like coryneform bacteria. With development with new molecular and biochemical analysis, the group was reclassified as Actinomyces based on 16sRNA. A. neuii is grampositive, predominantly a diphtheroidal bacillus, nitrate-reducing, catalase positive, facultatively anaerobic, and alpha-hemolytic. Isolates are obtained mainly from abscesses, blood cultures, and mixed anaerobic flora [6]. Actinomyces species in humans are normal flora in the oral cavity, upper respiratory, and gastrointestinal (GI) tract. Our patient did not have any recent known dental, skin, respiratory, or urinary tract infection around the time of surgery. Funke et al. reported on 67 patients with A. neuii infections [7]. Thirty patients (45%) presented as axillary, inguinal, mammary abscesses. Sixteen patients (24%) had atheromas, and nine patients (13%) had skin lesions, most of whom were immunocompromised. A. neuii was isolated from ejaculate and urine cultures from two patients (3%) with prostatitis and in another two with urinary tract infections, respectively. There was once case of fatal septicemia in a nonimmunocompromised patient.
925
A. neuii has been implicated in infections with several types of implants, including a mammary prosthesis [8], ventriculoperitoneal shunt [9], and prosthetic valve causing endocarditis [10]. Treatment included broad-spectrum intravenous antibiotics followed by narrowing to intravenous penicillin G or amoxicillin when culture sensitivities were known. The management of the infected hardware varied in each case. The infected ventriculoperitoneal shunt was removed and replaced with a temporary ventriculostomy drain. Twelve days later, a new ventriculoperitoneal drain was placed [9]. The infected prosthetic heart valve was treated with antibiotics without the removal of the valve [10]. During revision surgery for mechanical failure, the reservoir is routinely decommissioned and left in the prevesical space to prevent the morbidity of removal. Rajpurkar et al. evaluated the safety of retaining the decommissioned reservoir during replacement of an IPP for mechanical failure in 85 patients. Infection developed in one patient, and no patient had reservoir erosion into the bladder or bowel. The authors concluded that routine removal of reservoirs is not necessary [11]. In this case, infection appeared to be isolated to the decommissioned reservoir and the new IPP did not need to be removed. Now, after 4 months of follow-up, there is no evidence of infection of the new IPP, suggesting that preservation of the device is feasible in this unique clinical situation. A word of caution: Had the patient demonstrated any clinical evidence of infection in the current IPP or should the patient demonstrate evidence of this in the future, a more aggressive treatment course would have been or will be pursued with either a salvage operation or a simple device removal. Corresponding Author: Thomas J. Walsh, MD, MS, Department of Urology, University of Washington School of Medicine, 1959 NE Pacific Street, Box 356510, Seattle, WA 98195, USA. Tel: 206-543-3533; Fax: 206-543-3272; E-mail: [email protected] Conflict of Interest: TJ Walsh is a consultant for American Medical Systems. Statement of Authorship
Category 1 (a) Conception and Design Paul L. Bollyky; Thomas J. Walsh (b) Acquisition of Data Paul L. Bollyky; Thomas J. Walsh (c) Analysis and Interpretation of Data James M. Hotaling; Ryan S. Hsi; Thomas J. Walsh J Sex Med 2011;8:923–926
926
Category 2 (a) Drafting the Article Elysia S. Spencer; Ryan S. Hsi; James M. Hotaling (b) Revising it for Intellectual Content James M. Hotaling; Thomas J. Walsh; Ryan S. Hsi
Category 3 (a) Final Approval of the Completed Article Elysia S. Spencer; Ryan S. Hsi; James M. Hotaling; Thomas J. Walsh; Paul L. Bollyky
References 1 Carson CC, Mulcahy JJ, Govier FE. Efficacy, safety and patient satisfaction outcomes of the AMS 700CX inflatable penile prosthesis: Results of a long-term multicenter study. AMS 700CX Study Group. J Urol 2000;164:376–80. 2 Levine LA, Benson J, Hoover C. Inflatable penile prosthesis placement in men with Peyronie’s disease and drug-resistant erectile dysfunction: A single-center study. J Sex Med 2010; 7:3775–83. 3 Wilson SK, Delk JR 2nd. Inflatable penile implant infection: Predisposing factors and treatment suggestions. J Urol 1995; 153:659–61.
J Sex Med 2011;8:923–926
Hsi et al. 4 Henry GD, Carson CC, Wilson SK, Wiygul J, Tornehl C, Cleves MA, Simmons CJ, Donatucci CF. Revision washout decreases implant capsule tissue culture positivity: A multicenter study. J Urol 2008;179:186–90; discussion 90. 5 Mulcahy JJ. Long-term experience with salvage of infected penile implants. J Urol 2000;163:481–2. 6 Funke G, Stubbs S, von Graevenitz A, Collins MD. Assignment of human-derived CDC group 1 coryneform bacteria and CDC group 1-like coryneform bacteria to the genus Actinomyces as Actinomyces neuii subsp. neuii sp. nov., subsp. nov., and Actinomyces neuii subsp. anitratus subsp. nov. Int J Syst Bacteriol 1994;44:167–71. 7 Funke G, von Graevenitz A. Infections due to Actinomyces neuii (former “CDC coryneform group 1” bacteria). Infection 1995;23:73–5. 8 Brunner S, Graf S, Riegel P, Altwegg M. Catalase-negative Actinomyces neuii subsp. neuii isolated from an infected mammary prosthesis. Int J Med Microbiol 2000;290:285–7. 9 Watkins RR, Anthony K, Schroder S, Hall GS. Ventriculoperitoneal shunt infection caused by Actinomyces neuii subsp. neuii. J Clin Microbiol 2008;46:1888–9. 10 Grundmann S, Huebner J, Stuplich J, Koch A, Wu K, GeibelZehender A, Bode C, Brunner M. Prosthetic valve endocarditis due to Actinomyces neuii successfully treated with antibiotic therapy. J Clin Microbiol 2010;48:1008–11. 11 Rajpurkar A, Bianco FF Jr, Al-Omar O, Terlecki R, Dhabuwala C. Fate of the retained reservoir after replacement of 3-piece penile prosthesis. J Urol 2004;172:664–6.