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Immediate preoperative blood glucose and hemoglobin a1c levels are not predictive of postoperative infections in diabetic men undergoing penile prosthesis placement

International Journal of Impotence Research volume 33, pages 296–302 (2021)Cite this article

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Abstract

Defining the risks associated with diabetes mellitus in patients undergoing penile prosthesis implantation remains controversial. Our study aims to assess whether preoperative hemoglobin a1c and preoperative blood glucose levels are associated with an increased risk for postoperative infection in diabetic men. We performed a retrospective review of 932 diabetic patients undergoing primary penile prosthesis implantation from 18 high-volume penile prosthesis implantation surgeons throughout the United States, Germany, Belgium, and South Korea. Preoperative hemoglobin a1c and blood glucose levels within 6 h of surgery were collected and assessed in univariate and multivariate models for correlation with postoperative infection, revision, and explantation rates. The primary outcome is postoperative infection and the secondary outcomes are postoperative revision and explantation. In all, 875 patients were included in the final analysis. There were no associations between preoperative blood glucose levels or hemoglobin a1c levels and postoperative infection rates; p = 0.220 and p = 0.598, respectively. On multivariate analysis, a history of diabetes-related complications was a significant predictor of higher revision rates (p = 0.034), but was nonsignificant for infection or explantation rates. We conclude preoperative blood glucose levels and hemoglobin a1c levels are not associated with an increased risk for postoperative infection, revision, or explantation in diabetic men undergoing penile prosthesis implantation.

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References

  1. Burnett AL, Nehra A, Breau RH, Culkin DJ, Faraday MM, Hakim LS, et al. Erectile dysfunction: AUA guideline. J Urol. 2018;200:633–41. https://doi.org/10.1016/j.juro.2018.05.004.

    Article  PubMed  Google Scholar 

  2. Levine LA, Becher EF, Bella AJ, Brant WO, Kohler TS, Martinez-Salamanca JI, et al. Penile prosthesis surgery: current recommendations from the international consultation on sexual medicine. J Sex Med. 2016;13:489–518. https://doi.org/10.1016/j.jsxm.2016.01.017.

    Article  PubMed  Google Scholar 

  3. Huynh LM, Osman MM, Yafi FA. Risk profiling in patients undergoing penile prosthesis implantation. Asian J Androl. 2019. https://doi.org/10.4103/aja.aja_92_19.

  4. Narang GL, Figler BD, Coward RM. Preoperative counseling and expectation management for inflatable penile prosthesis implantation. Transl Androl Urol. 2017;6:S869–80. https://doi.org/10.21037/tau.2017.07.04.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Lipsky MJ, Onyeji I, Golan R, Munarriz R, Kashanian JA, Stember DS, et al. Diabetes is a risk factor for inflatable penile prosthesis infection: analysis of a large statewide database. Sex Med. 2019;7:35–40. https://doi.org/10.1016/j.esxm.2018.11.007.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Bishop JR, Moul JW, Sihelnik SA, Peppas DS, Gormley TS, McLeod DG. Use of glycosylated hemoglobin to identify diabetics at high risk for penile periprosthetic infections. J Urol. 1992;147:386–8. https://doi.org/10.1016/s0022-5347(17)37244-0.

    Article  CAS  PubMed  Google Scholar 

  7. Habous M, Tal R, Tealab A, Soliman T, Nassar M, Mekawi Z, et al. Defining a glycated haemoglobin (HbA1c) level that predicts increased risk of penile implant infection. BJU Int. 2018;121:293–300. https://doi.org/10.1111/bju.14076.

    Article  CAS  PubMed  Google Scholar 

  8. Wilson SK, Carson CC, Cleves MA, Delk JR 2nd. Quantifying risk of penile prosthesis infection with elevated glycosylated hemoglobin. J Urol. 1998;159:1537–9. https://doi.org/10.1097/00005392-199805000-00034.

    Article  CAS  PubMed  Google Scholar 

  9. Canguven O, Talib R, El Ansari W, Khalafalla K, Al Ansari A. Is Hba1c level of diabetic patients associated with penile prosthesis implantation infections? Aging Male. 2018;9:1–6. https://doi.org/10.1080/13685538.2018.1448059.

    Article  Google Scholar 

  10. Ogurtsova K, da Rocha Fernandes JD, Huang Y, Linnenkamp U, Guariguata L, Cho NH, et al. IDF diabetes atlas: global estimates for the prevalence of diabetes for 2015 and 2040. Diabetes Res Clin Pr. 2017;128:40–50. https://doi.org/10.1016/j.diabres.2017.03.024.

    Article  CAS  Google Scholar 

  11. Okonkwo UA, DiPietro LA. Diabetes and wound angiogenesis. Int J Mol Sci. 2017;18:E1419. https://doi.org/10.3390/ijms18071419.

    Article  PubMed  Google Scholar 

  12. Wang R, Panizales MT, Hudson MS, Rogers SO, Schnipper JL. Preoperative glucose as a screening tool in patients without diabetes. J Surg Res. 2014;186:371–8. https://doi.org/10.1016/j.jss.2013.09.014.

    Article  CAS  PubMed  Google Scholar 

  13. Davis MC, Ziewacz JE, Sullivan SE, El-Sayed AM. Preoperative hyperglycemia and complication risk following neurosurgical intervention: a study of 918 consecutive cases. Surg Neurol Int. 2012;3:49. https://doi.org/10.4103/2152-7806.96071.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Shalaurova I, Connelly MA, Garvey WT, Otvos JD. Lipoprotein insulin resistance index: a lipoprotein particle-derived measure of insulin resistance. Metab Syndr Relat Disord. 2014;12:422–9. https://doi.org/10.1089/met.2014.0050.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Harada PHN, Demler OV, Dugani SB, Akinkuolie AO, Moorthy MV, Ridker PM, et al. Lipoprotein insulin resistance score and risk of incident diabetes during extended follow-up of 20 years: the Women’s Health Study. J Clin Lipido. 2017;11:1257–67.e2. https://doi.org/10.1016/j.jacl.2017.06.008.

    Article  Google Scholar 

Download references

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Authors and Affiliations

  1. Department of Urology, Irvine Medical Center, University of California, Orange, CA, USA

    Mohamad M. Osman, Linda M. Huynh, Farouk M. El-Khatib, Maxwell Towe, Huang-Wei Su & Faysal A. Yafi

  2. Service d’urologie, Centre Hospitalier Universitaire de Liège, Liège, Belgium

    Robert Andrianne & Maxime Sempels

  3. Division of Urology, Duke University Medical Center, Durham, NC, USA

    Gregory Barton & Aaron Lentz

  4. Department of Urology, Mayo Clinic, Jacksonville, FL, USA

    Gregory Broderick & Kevin Parikh

  5. The Johns Hopkins Hospital, Baltimore, MD, USA

    Arthur L. Burnett & Jeffrey D. Campbell

  6. University of Texas, MD Anderson Cancer Center, Houston, TX, USA

    Jonathan Clavell-Hernandez, Ross Guillum & Run Wang

  7. Department of Urology, Hackensack University Medical Center, Hackensack, NJ, USA

    Jessica Connor & Hossein Sadeghi-Nejad

  8. Section of Urology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA

    Martin Gross

  9. Department of Urology, Medical College of Wisconsin, Milwaukee, WI, USA

    Amy I. Guise

  10. Department of Urology, Julius-Maximilians-University of Würzburg, Würzburg, Germany

    Georgios Hatzichristodoulou

  11. ArkLaTex Urology, Bossier City, LA, USA

    Gerard D. Henry

  12. Department of Urology, UC San Diego Health System, San Diego, CA, USA

    Tung-Chin Hsieh & Christopher Koprowski

  13. Department of Urology, The Ohio State University, Columbus, OH, USA

    Lawrence C. Jenkins

  14. Sewum Prosthetic Urology Center of Excellence, Seoul, South Korea

    Kook B. Lee & Sung Hun Park

  15. Department of Urology, Boston University Medical Center, Boston, MA, USA

    Ricardo M. Munarriz & Shu Pan

  16. Department of Urology, University Hospital Schleswig Holstein, Campus Kiel, Germany

    Daniar Osmonov

  17. Department of Urology, Fox Chase Cancer Center, Einstein Healthcare Network, Philadelphia, PA, USA

    Amir S. Patel & Jay Simhan

  18. Perito Urology, Coral Gables, FL, USA

    Paul Perito

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  1. Mohamad M. Osman
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  2. Linda M. Huynh
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  15. Amy I. Guise
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  16. Georgios Hatzichristodoulou
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  19. Lawrence C. Jenkins
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  21. Kook B. Lee
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  23. Ricardo M. Munarriz
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  24. Daniar Osmonov
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  25. Shu Pan
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  26. Kevin Parikh
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  27. Sung Hun Park
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  30. Hossein Sadeghi-Nejad
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  31. Maxime Sempels
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  32. Jay Simhan
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  33. Run Wang
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  34. Faysal A. Yafi
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Corresponding author

Correspondence to Faysal A. Yafi.

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Conflict of interest

FAY reports associations with Endo Pharmaceuticals as consultant and speaker; Antares Pharma as consultant and speaker; Coloplast as speaker and advisory board; and Viome as clinical trial primary investigator. All other authors declare that they have no conflict of interest.

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Osman, M.M., Huynh, L.M., El-Khatib, F.M. et al. Immediate preoperative blood glucose and hemoglobin a1c levels are not predictive of postoperative infections in diabetic men undergoing penile prosthesis placement. Int J Impot Res 33, 296–302 (2021). https://doi.org/10.1038/s41443-020-0261-5

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