TRENDS AGAINST PENILE PROSTHESIS INFECTIOUS COMPLICATIONS IN DIABETIC PATIENTS: A SYSTEMATIC REVIEW AND META-ANALYSIS
Background: penile prosthesis had many developments reducing mechanical and infectious complications. Infection has been a feared complication as it can lead to reoperation, penile shortening and scaring, but there are controversial data about risk factors like diabetes mellitus (DM).
Objectives: to gather wide range information about penile prosthesis infection and complications, summarize the contribution of technique and material improvements; present the current state of device infection and survival and a meta-analysis specially focused on DM contribution to penile prosthesis infection.
Methods: the review was performed with no language or time limitation, in 10 data bases. There were included articles about male population who received a penile prosthesis with no model restriction, with a minimum follow up of one year and that reported outcomes and complications properly.
Results: The mean incidence of infection in studies that included a first implant of penile prosthesis ranged from 0.33 to 11.4%. After several improvements, the general incidence of infection was 3 to 5%, in early 2000, and after coating introduction it decreased to 0.3 to 2.7% in naive patients. Also “no touch” technique and centers of reference with high volume surgeons contributed to reduce infection rates. Meta-analysis showed that diabetes mellitus increases infection with odds ratio of 1.56 (95% CI: 1.12 - 2.044).
Conclusions: Penile prosthesis infection decreased in the last decades due to several improvements, but remains an important cause of reoperation and it is related to decreased prosthesis survival. Meta-analysis indicate that diabetes mellitus increases risk of penile prosthesis infection, but studies are needed to define the contribution of disease treatments and glycemic control
penile prosthesis; penile implants; outcomes; infection; review; meta-analysis; diabetes mellitus
universidade estadual de campinas - UNICAMP - Sao Paulo - Brasil
Lucas Mira Gon, Caio César Citatini de Campos, Brunno Raphael Iamashita Voris, Arnold Acherman, Danilo Leite Andrade, Fabio Coltro Neto, Paulo Vitor Barreto, Rodrigo Gonzalez Bocos, Adriano Fregonesi, Cássio Luís Zanettini Riccetto