0.05% Chlorhexidine gluconate is not associated with infection in antibiotic impregnated inflatable penile prosthesis surgery: results from a large multi-institutional collaborative.
Publication/Presentation Date
1-5-2026
Abstract
BACKGROUND: 0.05% Chlorhexidine gluconate (CHG) is now commonly used as an antiseptic irrigation for inflatable penile prosthesis (IPP) surgery. Limited in vitro data suggest compatibility of 0.05% CHG with antibiotic impregnated IPP devices; however, very little clinical research exists to guide use of 0.05% CHG in this population.
AIM: Assess the relationship of 0.05% CHG and antibiotic impregnated IPP infection in a large multi-institutional cohort.
METHODS: We retrospectively reviewed a multi-institutional cohort of patients who underwent antibiotic impregnated IPP implantation. We identified cases using intraoperative 0.05% CHG and an equal number of consecutive control cases without 0.05% CHG use from each center for comparison. The primary outcome was IPP infection requiring explantation. Patient demographics and surgical variables were analyzed using chi-square tests and multivariable logistic regression to identify variables associated with infection.
OUTCOMES: The primary outcome was IPP infection requiring device explanation.
RESULTS: Among 14 participating institutions, 761 cases using an antibiotic impregnated IPP were analyzed. Of these, 348 (45.7%) had 0.05% CHG used during the case. Median follow-up was 4 months (interquartile range 1-12) for the 0.05% CHG group and 8 months (interquartile range 2-21) for the control group.Intraoperative 0.05% CHG utilization was not associated with antibiotic impregnated IPP infection rate (1.9% vs. 2.0%, P = .9). On multivariable analysis, prior IPP infection (OR 6.32, 95% CI 1.32-30.2, P = .021) and prior priapism (OR 10.01, 95% CI 1.18-89.7, P = .039) were associated with increased infection risk.
CLINICAL IMPLICATIONS: The use of 0.05% CHG irrigation with antibiotic impregnated IPPs was associated with similar infection rates compared to antibiotic irrigation.
STRENGTHS AND LIMITATIONS: Limitations include the use of a historical comparator cohort which may introduce unknown confounders, practice variation between multiple sites, shorter follow-up in the 0.05% CHG cohort, and the low incidence of IPP infection which may limit statistical power despite a large sample. The major strengths include the large, multi-institutional cohort, and the use of consecutive patients to minimize selection bias.
CONCLUSION: 0.05% CHG utilization was not associated with infection rates in antibiotic impregnated IPPs.
Volume
23
Issue
1
ISSN
1743-6109
Published In/Presented At
Ivan, S. J., Abou Chawareb, E., Hammad, M., Lesgart, M., Baird, B., Bajic, P., Barham, D. W., Bernie, H. L., Bole, R., Chung, P., Cowan, K., Dominick, Z., Good, J., Helo, S., Hsieh, M. H., Im, B. H., Kadakia, Y., Kohler, T., Lentz, A. C., Mass-Lindenbaum, M., … Simhan, J. (2026). 0.05% Chlorhexidine gluconate is not associated with infection in antibiotic impregnated inflatable penile prosthesis surgery: results from a large multi-institutional collaborative. The journal of sexual medicine, 23(1), qdaf368. https://doi.org/10.1093/jsxmed/qdaf368
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
41489194
Department(s)
Administration and Leadership
Document Type
Article