Lozoya, A Gullen

Abstract Introduction The optimal antimicrobial prophylaxis strategy for inflatable penile prosthesis (IPP) surgery remains a subject of ongoing investigation. Our institution recently discontinued the use of chlorhexidine gluconate (CHG) and returned to traditional antibiotic-based prophylaxis protocols. Objective To evaluate infection rates following the reinstitution of antibiotic-based prophylaxis after discontinuing CHG in IPP surgery. Methods We conducted a retrospective, consecutive cohort study of patients who underwent Coloplast Titan IPP insertion between May 2024 and May 2025. The antibiotic prophylaxis protocol consisted of rifampin/gentamicin device dipping and vancomycin/gentamicin irrigation. Primary and revision cases were analyzed separately. Results A total of 188 patients underwent IPP insertion during the study period, including 119 primary implantations and 69 revision procedures. Mean patient age was 69.6 ± 11.5 years, BMI was 27.6 ± 4.2 kg/m2, and operative time was 67.1 ± 24.1 minutes. No infections occurred in the primary implantation cohort. One infection (1.4%) occurred in the revision group in a diabetic patient with prolonged operative time (176 minutes). Compared to our previously published data using CHG, infection rates decreased significantly in the revision group (1.4% vs. 9.67%, p < 0.001), while the primary group showed a numerical reduction from 2.22% to 0%. Conclusions The reinstitution of antibiotic following discontinuation of CHG resulted in significantly lower infection rates, particularly in revision cases. These findings support the continued use of antibiotic dipping and irrigation protocols for IPP surgery as a safe and effective strategy for infection prevention. Disclosure No