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Infection rate of penile prosthesis implants in men with spinal cord injury: a meta-analysis of available evidence

International Journal of Impotence Research volume 36, pages 206–213 (2024)Cite this article

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Abstract

The risk of penile prosthesis implants (PPIs) infection in men with spinal cord injury (SCI), empirically theorized to be high, is widely variable among the studies. We performed a meta-analysis to define the pooled PPI infection rate and its possible risk factors in men with SCI. A thorough search of PubMed, Scopus and Web of Science was performed. The eighteen included studies provided information on 1079 implantation procedures, determining a pooled PPI infection rate of 8.0% (95% CI: 5.0–11.0%), with significant heterogeneity (I² = 67.0%). Trim-and-fill adjustment for publication bias had a small effect on the pooled estimate (adjusted odds ratio: 6.3%, 95% CI: 2.5–10.0%) with a substantial reduction in heterogeneity (I2 = 32.4%). The PPI infection rate was higher for inflatable PPIs than for malleable PPIs (16.4% vs 8.9%, p = 0.027). No differences were found between the different levels of SCI. In conclusion, the risk of PPI infection in SCI would be higher than that reported in the general population. However, the results were produced from dated and low/moderate quality studies that may not fully reflect the outcomes of modern PPIs and implantation protocols. There is an urgent need to gather more information on this topic through studies relevant to contemporary practice.

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Fig. 1: Flow diagram showing an overview of the study selection process.
Fig. 2: Forest plot depicting the pooled infection rate of the penile prosthesis implant (PPI) in men with spinal cord injury.
Fig. 3: Funnel plot of results from studies assessing the infection rate of the penile prosthesis implant (PPI) in men with spinal cord injury.

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All data generated or analyzed during this study are included in this published article.

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Authors and Affiliations

  1. Andrology Unit, Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy

    Daniele Tienforti, Maria Totaro, Luca Spagnolo, Francesca Di Giulio, Chiara Castellini, Marco Giorgio Baroni, Sandro Francavilla & Arcangelo Barbonetti

  2. Spinal Unit, San Raffaele Sulmona Institute, Sulmona, Italy

    Giorgio Felzani

  3. Neuroendocrinology and Metabolic Diseases, IRCCS Neuromed, Pozzilli, Italy

    Marco Giorgio Baroni

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  1. Daniele Tienforti
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  2. Maria Totaro
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Contributions

Conceptualization, Writing-Reviewing and Editing: AB, DT and MT. Systematic search: MT, LS and FDG. Evaluation of the full text of all selected studies for eligibility: DT, MT, CC and AB. Data extraction from the selected studies: DT, MT and LS. Quality assessment: DT, MT and CC. Statistical analysis and interpretation of data: DT, MT, CC and AB. Supervision and critical review of the manuscript: GF, MGB and SF. Manuscript writing and final approval of manuscript: all authors.

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Correspondence to Arcangelo Barbonetti.

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Tienforti, D., Totaro, M., Spagnolo, L. et al. Infection rate of penile prosthesis implants in men with spinal cord injury: a meta-analysis of available evidence. Int J Impot Res 36, 206–213 (2024). https://doi.org/10.1038/s41443-022-00632-x

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