Why is NTT so important?
The rate of penile implant infection in the US is believed to be between 2 to 5%. However, it is known fact that penile surgery infections are underreported and that in addition, no national registry is currently in place tracking infection rates. It is up to the individual penile surgeon to decide whether or not to report and track the occurrence of an infection.It is also well recognized that infections are much more prevalent in institutions where the penile implant procedure is not often performed and that 70% of penile implants are performed by a urologist who performs 1 to 3 penile implants per year. This is often the case for large medical centers and institutions that are excellent for the treatment of major illnesses and cancers but are not set up for or do not prioritize for minor delicate “plastic like” procedures. In these instances, physicians may only quote the available published infection rate of experienced penile implanters when discussing the potential risks and side effects of the penile surgery rather than their own data. Finally, to add insult to injury, the reimbursement to physicians is higher for removing an infected penile implant than for the initial surgery to put one in. When a penile implant is infected, the clinical signs and symptoms of an infection become noticeable between the 2nd and 6th week after penile surgery, the entire implant device will need to be removed and a salvage procedure may or may not be attempted. This involves the simultaneous replacement of the infected implant with a non-infected penile device, concomitant with a prolonged course of oral or intravenous course of antibiotics. The failure rate of the salvage procedure is quite high (20%) and a subsequent failure requires a third operation to completely remove the implanted penile device without replacing it with another. Left without cylinders, the penis will then retract, shrink and scar, permanently reducing the size, length and girth of the penis. In addition, all subsequent penile surgeries will be extremely difficult with a less than desirable outcome.
It is Dr. Eid’s philosophy that it is much better to do everything possible to prevent a penile infection rather than to having to treat one. It is, therefore, logical to add the NTT to all other available techniques to further reduce the risk of infection after the penile implant surgery.
Penile Implant Surgery: Objectives and Strategy
World-renowned urologist Dr. J. Francois Eid talks about his objectives and strategy when placing a penile implant (penis pump) to treat erectile dysfunction.