PurposePrimary care providers harbor misconceptions regarding penile prosthetic surgery, largely overestimating the rate of infection. Rates of infection following surgery for primary placement and revision are estimated as 1% to 3% and 10% to 18%, respectively. Our objective was to determine the contemporary incidence of infection following inflatable penile prostheses surgery at an academic training center where surgeons-in-training are routinely involved.Materials and MethodsReview of a prospectively collected single-surgeon database was performed. All cases of inflatable penile prostheses placement from January 2011 through June 2017 were reviewed. Information regarding training level of assistant surgeon(s) was collected, and follow-up data was compiled regarding postoperative infections and need for revision surgery.ResultsThree hundred nine cases meeting inclusion criteria were identified. Mean patient age was 64.2 years, and mean follow-up was 28.7 months. Distribution involved 257 (83.2%) for primary placement, 45 (14.6%) for removal/replacement, and 7 (2.3%) in setting of prior device removal. Diabetes was noted in 31.1% of men. Surgeon-in-training involvement was noted in 100% of cases. Infection was confirmed in a patient who had skin breakdown over an area of corporal reconstruction with polytetrafluoroethylene. The overall postoperative infection rate was 0.3%.ConclusionsIn this series from an academic training center, infection following penile prosthetic surgery is low, similar to other centers of excellence, even with 100% involvement of surgeons-in-training. This data should be used to better inform primary care providers and members of the general public potentially interested in restoration of sexual function.

Background: Reconstruction for complex urethral strictures may necessitate grafting. Buccal mucosal graft (BMG) harvest involves additional morbidity, making 'off-the-shelf' options attractive. Multiple extracellular matrices (ECMs) have been used with varying degrees of success. We reviewed our experience with MatriStem (ACell, Inc., Columbia, MD, USA) to assess safety and clinical/histologic outcomes. Methods: All patients undergoing acellular matrix-based reconstruction were included. Data regarding indications for surgery, patient demographics, subsequent procedures, clinical outcomes, and histologic analysis, when present, were collected. Results: Eight patients undergoing urethral reconstruction with ECM were identified. All repairs were performed as staged procedures. Grafting was performed with either MatriStem alone or MatriStem and concomitant BMG. Seven patients (88%) underwent prior endoscopic intervention and five patients (71%) had failed to respond to one or multiple prior urethroplasties. Length of involved segments ranged from 2.5 to 15 cm. ECM graft placement was feasible and demonstrated excellent graft take. Among patients undergoing second-stage repairs (four of eight, 50%), 50% remained patent without the need for subsequent dilation. Conclusions: Use of acellular matrix grafts in urethral reconstruction appears safe and feasible. Acellular matrix performs similarly to BMG with respect to graft take and contraction following staged repair. Further study is warranted.

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