Diabetes and the Risk of Penile Prosthesis Infection
Infection is one of the more aggravating possible complications of any prosthesis surgery. The reason is that an infected prosthesis, such as an artificial knee or hip, generally has to be surgically removed, the reason for which is that an infected prosthesis is relatively insensitive to antibiotics. For this reason, strict attention is paid to surgical technique and infection prevention protocols. For example, prosthesis implant surgery limits the number of people in the room during surgery and does not allow people to enter and leave while the prosthesis is exposed.
Patient factors can also affect the risk of prosthesis infection. For example, conditions that affect blood flow to the surgical site can affect the likelihood of infection. Among these, diabetes mellitus is a very good example and has generally been thought of as a factor that risk of infection. Is that really the case?
A study soon to be published in Surgical Infections examined the association of diabetes mellitus with infections of penile prostheses. The study specifically looked at 38 studies identifiable through online searches that were published over a 44-year period. Studies published from the 1970s to the 1990s found a higher likelihood of infection in patients with diabetes. These studies were based on a relatively small number of patients. By contrast, in the 1990s, studies had more patients and found lower likelihood of infection in patients with diabetes relative to what was observed with patients with such conditions as paraplegia. The best reported results were by a single, high-volume implanter who found a 0.46% likelihood of infection. In his study, almost half the patients had diabetes.
The review suggests that the likelihood of infection has dropped over the decades in which penile implant surgery has developed and matured. It also suggests that, in association with dropping overall likelihood of infection, the risk of infection in patients with diabetes is also very low and not different statistically from what is seen in the general population.
While it seems obvious that, with or without diabetes, the surgeon should carefully follow protocols to limit infection, it is encouraging to see that overall the risk of infection is low. Low or high, penile implant infection is included in the complications protection that is included in every Surgeo penile implant surgery package.
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