Scrotal Abscess Precipitating Late Infection of a Malleable Penile Prosthesis: The Risk Never Evanesces

Although infrequent, infections represent the dreadful complication of penile prosthesis implantation. The incidence substantially decreases after a few infection-free postoperative months. We report herein a case of a very late penile prosthesis infection from a fistualizing scrotal abscess in a 67-year-old man. The patient presented with a one-month history of persistent penile-base discharge from a right hemiscrotal swelling. On examination, mild penile tenderness and a discharging penoscrotal-junction sinus were noted. Microbiological wound culture was positive for Staphylococcus epidermidis. Magnetic resonance imaging revealed this multiloculated fluid collection's communication with the right corporal body. Removal of the prosthesis was performed. Pathological evaluation of the dissected fistula was suggestive of acute on top of chronic inflammatory reactions. To our knowledge, this is the first report of a scrotal abscess leading to penile prosthesis infection 15 years after an uneventful implantation.