Poor sterilization of Furlow insertion instrument may be source of penile prosthesis infections

The improper cleaning and/or sterilization of the Furlow insertion may be a source of implant infection in patients receiving penile prostheses (PPs), a recent study has found.

Researchers prospectively assessed 83 cultures from Furlow devices, the median age of which was 4 years. Swabs of aerobic and anaerobic bacteria, along with fungi, were obtained from the implants. After receiving the device, the medical team also conducted visual examinations for assembly status, and the presence of stains, tissues, and discolorations.

Device sterilization procedures included autoclave, wet autoclave, and steam. Upon inspection, 79 devices (95.1 percent) were disassembled, while four (4.9 percent) were still assembled.

Discoloration of three external components were noted, yielding a rate of 3.6 percent. Staining in internal components was observed in two instances (2.4 percent). Both discoloration and staining were taken as indicators of improper cleaning of residual blood products.

Overall, two devices were positive for swab cultures of Staphylococcus epidermidis, resulting in a rate of 2.4 percent. Both of these devices were presented disassembled and had no signs of discoloration or staining. There were no positive cultures for fungi or anaerobic bacteria.

“Improper cleaning and/or sterilization of the Furlow insertion instrument may represent a source of infection for patients undergoing PP implantation,” the researchers said. “Perhaps a disposable Furlow inserter might offer the opportunity to reduce the risks of contamination associated with improper instrument handling and impact the rate of device infection.”