Diabetes Increases Penile Prosthesis Infection Risk

Diabetic men receiving an inflatable penile prosthesis have a 69% increased risk of device-associated infection compared with non-diabetics.
Diabetic men receiving an inflatable penile prosthesis have a 69% increased risk of device-associated infection compared with non-diabetics.
The following article is part of conference coverage from the 2017 American Urological Association meeting in Boston. Renal and Urology News' staff will be reporting live on medical studies conducted by urologists and other specialists who are tops in their field in kidney stones, prostate cancer, kidney cancer, bladder cancer, enlarged prostate, and more. Check back for the latest news from AUA 2017. 

BOSTON—Diabetes mellitus is a risk factor for inflatable penile prosthesis (IPP) infection, investigators reported at the American Urological Association 2017 annual meeting.

Using the New York Statewide Planning and Research Cooperative System database, Michael J. Lipsky, MD, of Columbia University Medical Center in New York, and colleagues identified 14,969 men who underwent initial IPP from 1995 to 2014. Of these, 343 (2.3%) experienced infection at a median 3.9 months after implantation. Dr Lipsky's group divided the study period into 2 time periods—1995–2003 and 2004–2014—representing eras before and after the widespread availability of antibiotic impregnated penile prostheses, respectively.

In the era before the use of antibiotic impregnated IPPs, infection rates in diabetic and non-diabetic men were 5.2% and 3.2%, respectively. In the contemporary era of antibiotic impregnated IPPs, infection rates in diabetic and non-diabetic men were 2% and 1.1%, respectively.

On multivariate analysis controlling for age, comorbidity index, and annual surgeon volume, IPP recipients with diabetes mellitus had a significant 43% and 69% increased risk of IPP infection in eras before and after the use of antibiotic impregnated implants, respectively, compared with non-diabetics.

“This has important implications for patient selection and counseling, and raises the question of whether this increased risk can be mitigated by optimization of glycemic control prior to surgery,” the investigators concluded.

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Reference

Lipsky MJ, Golan R, Onyeji I, et al. Diabetes is a risk factor for IPP infection: Analysis of a large statewide database. [abstract] J Urol 2017;197(S4):e314-e315. Poster presented at the American Urological Association 2017 annual meeting in Boston on May 13, 2017. Poster MP25-12.

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