Diabetes Is a Risk Factor for Inflatable Penile Prosthesis Infection: Analysis of a Large Statewide Database.
Diabetes
Erectile Dysfunction
IPP
Infection
Penile Implant
Journal
Sexual medicine
ISSN: 2050-1161
Titre abrégé: Sex Med
Pays: England
ID NLM: 101631053
Informations de publication
Date de publication:
Mar 2019
Mar 2019
Historique:
received:
19
10
2018
revised:
06
11
2018
accepted:
14
11
2018
pubmed:
25
1
2019
medline:
25
1
2019
entrez:
25
1
2019
Statut:
ppublish
Résumé
Although diabetes mellitus (DM) is often discussed as a risk factor for inflatable penile prosthesis (IPP) infection, the link between DM diagnosis and IPP infection remains controversial. High-quality population-based data linking DM to an increased risk of IPP infection have not been published. To evaluate the association of DM with IPP infection in a large public New York state database. The New York Statewide Planning and Research Cooperative System (SPARCS) database was queried for men who underwent initial IPP insertion from 1995-2014. Diabetic patients were identified using ICD-9-CM codes. Patients presenting for first operation with diagnosis or Current Procedural Terminology codes suggestive of prior IPP surgery were excluded. Chi-squared analyses were performed to compare infection rates in diabetics and non-diabetics within the pre- and postantibiotic impregnated eras. Multivariate Cox proportional hazards models were constructed to evaluate whether or not DM was independently associated with IPP infection in the time periods before (1995-2003) and after (2004-2014) the widespread availability of antibiotic impregnated penile prostheses. Time to prosthesis infection was measured. 14,969 patients underwent initial IPP insertion during the study period. The overall infection rate was 343/14,969 (2.3%). Infections occurred at a median 3.9 months after implant (interquartile ratio: 1.0-25.0 months). Infectious complications were experienced by 3% (133/4,478) of diabetic patients and 2% (210/10,491) of non-diabetic patients (P < .001). Diabetes was associated with a significantly increased IPP infection risk on multivariable analysis controlling for age, race, comorbidities, insurance status, annual surgeon volume, and era of implantation (Hazard Ratio: 1.32, 95% CI: 1.05-1.66, P = .016). Our analysis supports the notion that DM is a risk factor for IPP infection. 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 before surgery. Lipsky MJ, Onyeji I, Golan R, et al. Diabetes Is a Risk Factor for Inflatable Penile Prosthesis Infection: Analysis of a Large Statewide Database. Sex Med 2019;7:35-40.
Identifiants
pubmed: 30674445
pii: S2050-1161(18)30117-X
doi: 10.1016/j.esxm.2018.11.007
pmc: PMC6377380
pii:
doi:
Types de publication
Journal Article
Langues
eng
Pagination
35-40Informations de copyright
Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.
Références
J Urol. 2000 Feb;163(2):460-3
pubmed: 10647654
Med Biol Eng Comput. 1999 Sep;37(5):625-31
pubmed: 10723901
Urology. 2003 Nov;62(5):918-21
pubmed: 14624920
J Urol. 2004 Apr;171(4):1611-4
pubmed: 15017233
J Urol. 2005 Jul;174(1):230-9
pubmed: 15947645
Am J Med. 2007 Feb;120(2):151-7
pubmed: 17275456
J Urol. 1992 Feb;147(2):386-8
pubmed: 1732600
Urology. 2007 Aug;70(2):337-40
pubmed: 17826502
Eur Urol. 2011 Jul;60(1):167-72
pubmed: 21316145
J Diabetes Sci Technol. 2011 May 01;5(3):605-18
pubmed: 21722576
J Sex Med. 2012 Jan;9(1):309-15
pubmed: 22082149
Urology. 2012 Jun;79(6):1310-5
pubmed: 22521187
J Sex Med. 2012 Aug;9(8):2182-6
pubmed: 22759917
J Urol. 2012 Nov;188(5):1855-60
pubmed: 22999690
Breast J. 2013 Nov-Dec;19(6):618-26
pubmed: 24011080
Int J Impot Res. 2014 May-Jun;26(3):112-5
pubmed: 24352244
Curr Diab Rep. 2014;14(11):545
pubmed: 25193347
J Sex Med. 2016 Apr;13(4):697-701
pubmed: 26928774
PLoS One. 2016 Mar 03;11(3):e0150866
pubmed: 26938768
J Urol. 2017 Jan;197(1):223-229
pubmed: 27545573
J Urol. 1995 Mar;153(3 Pt 1):659-61
pubmed: 7861509
J Urol. 1996 Aug;156(2 Pt 1):402-4
pubmed: 8683689
Med Care. 1998 Jan;36(1):8-27
pubmed: 9431328
J Urol. 1998 May;159(5):1537-9; discussion 1539-40
pubmed: 9554349
Urology. 1998 Aug;52(2):291-3
pubmed: 9697797