Objectives : To explore the association between HbA1C level and penile
implant infection rates and to define a cut-off value that predicted implant
infection.
Patients and Methods:A multi center prospective study included all patients
undergoing penile implant surgery between 2009-15. Preoperative,
perioperative and postoperative management were identical for the entire
cohort. Univariate analysis was performed to define predictors of implant
infection. HbA1c levels were analyzed as a continuous variable and
sequential analysis was conducted utilizing 0.5% increments to define a
cut-off level predicting implant infection. Multivariable analysis was
performed with the following factors entered the model: Diabetes, HbA1C
level, patient age, implant type, vascular risk factor number, presence of
Peyronie’s disease (PD), BMI and surgeon volume. A ROC curve was
generated to define the optimal HbA1C cut-off for infection prediction.
Results : 902 implant procedures were performed over this period of time.
The mean age was 56.6 years. The mean HbA1c level was 8.0, with 81%
of men having a HbA1c >6%. 685 (76%) implants were malleable, and
217 (24%) were inflatable devices. 302 (33.5%) patients had also a
diagnosis of PD. Overall infection rate was 8.9% (80/902 subjects).
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Patients who had implant infection had significantly higher mean HbA1c
levels, 9.5% vs 7.8% (p |
