A systematic review of penile prosthesis infection and meta-analysis of diabetes mellitus role

Abstract

Background Infection is the most feared complication of a penile prosthesis. Diabetes mellitus (DM) is widely known to increase the risk of several infections, but its role in the penile prosthesis is still controversial. This systematic review aims to show the contemporary scenario of penile prosthesis infection and present a meta-analysis about DM contribution to penile prosthesis infection. Methods The review was performed with no language or time limitation, including ten databases. The included articles were about the male population who received a penile prosthesis with no model restriction, with a minimum follow up of 1 year, and outcomes adequately reported. Results The mean infection incidence of penile prosthesis ranged from 0.33 to 11.4%. In early 2000, the general incidence of infection was 3 to 5%, then, the introduction of coated materials decreased it to 0.3 to 2.7%. The meta-analysis showed that diabetes mellitus is related to an increased risk of penile prosthesis infection with an odds ratio of 1.53 (95% CI 1.15–2.04). Conclusions Penile prosthesis infection decreased in the last decades but remains a significant cause of reoperation, and it is related to lower prosthesis survival. Meta-analysis concludes that diabetes mellitus is related to a higher risk of penile prosthesis infection.

Long-Term Survival Rates of Inflatable Penile Prostheses: Systematic Review and Meta-Analysis

“…Finally, the specific causes of device failure were inconsistently reported overall and, therefore the contribution of mechanical or infectious factors was unable to be quantified. Risk factors for device infection are well characterized and include use of non-antibiotic impregnated implants, 32 diabetes mellitus, 9 and repeat surgery. 8 However, it is likely that the majority of failures in this review were mechanical in nature since approximately 90% of infections occur within 1 year of implant.…”

“…Current evidence on PP device durability is derived from individual reports, literature reviews without metaanalysis, 6,7 or meta-analyses focused only on device infection rates. [8][9][10] No known meta-analysis has been performed to objectively synthesize the existing PP literature base regarding all-cause device survival. The primary aim of this systematic review with meta-analysis was to determine the long-term survival rate of inflatable PP in men with ED.…”

Outcomes of artificial urinary sphincter implantation in patients with diabetes mellitus: A subgroup analysis

“…DM is widely known to increase the risk of surgical complications, infection, or protracted wound healing. Thus, considerable attention is required, especially during surgery for the insertion of artificial material in patients with DM 17–19 . All patients with DM in the present study had received medical care before AUS surgery and were followed up thereafter according to glycemic control guidelines.…”

Peyronie's disease development and management in diabetic men

“…54 These observations were confirmed by a recent meta-analysis in which DM was found to be related to a higher risk of penile prosthesis infection with an odds ratio of 1.53. 55 These findings regarding DM and PD's treatment may not have a major role in the current care algorithm. However, potential effects on treatments result (decrease in the incidence of curvature recurrence and increased risk of implant infection) should be fully discussed with the patient in order to modulate his expectations and to be aware of the possible therapeutic outcomes.…”