Perioperative antifungal use helps lower infection risk in penile prosthesis surgery
01 Dec 2025
Perioperative antifungal prophylaxis appears to reduce the risk of infection in patients undergoing inflatable penile prosthesis surgery, suggests a study.
Some 5,261 patients who underwent primary or revision inflatable penile prosthesis surgery at 16 specialized centres across the US, Europe, and Korea from July 2016 to July 2021 were included in this multicentre, retrospective cohort study.
The investigators examined patient data, including demographic and clinical characteristics, antibiotic and antifungal administration, and infection outcomes. Infection after the procedure was the primary outcome. Predictors of infection were identified via univariable and multivariable regression analyses.
Overall, the infection rate stood at 1.9 percent (n=102). Infections occurred more frequently among patients with diabetes (p=0.023), those with prior inflatable penile prosthesis infection (p<0.001), or undergoing revision surgery (p<0.001).
In multivariable analysis, diabetes (odds ratio [OR], 1.68; p=0.022) and previous inflatable penile prosthesis infection (OR, 4.67; p<0.001) independently predicted infection.
Perioperative intravenous (IV) antifungal use significantly correlated with a lower risk of infection (OR, 0.22; p<0.001), while postoperative oral antibiotics (p=0.5) and prolonged IV antibiotic prophylaxis (>24 h; p=0.2) offered no protective benefits.
Furthermore, pre- and postoperative oral antibiotics showed no significant association with reduction in infection following adjustment for confounding variables.
“This large multicentre study highlights a significant association between perioperative antifungal prophylaxis and lower infection risk in inflatable penile prosthesis surgery while demonstrating the limited utility of preoperative and postoperative oral antibiotics and prolonged IV prophylaxis,” the investigators said.
“These findings support evidence-based antimicrobial stewardship to optimize outcomes and minimize complications, including antibiotic resistance,” they added.