INTRODUCTION AND OBJECTIVES:
Introduction: The most catastrophic complication of penile prosthesis surgery(PPS) is infection which is more common in diabetics. It was reported that glycosylated hemoglobin(HbA1c), as a marker for diabetic control, was correlated with infection rate.
Objectives:
To check if the fasting blood sugar(FBS) at the time of PPS is correlated with the outcome.
METHODS:
Based on a prospective study, we retrospectively analyzed the data of penile implant procedures in one full year (2015) in one facility. We excluded non-diabetics, revision surgery and procedures done by low volume surgeons. Preoperative, intraoperative and postoperative protocols were identical for all patients. We recorded all minor (oedema, echymosis, pain) and major (infection, erosion, mechanical failure) complications as early as 4 weeks and followed up to 3 years. A Likert scale questionnaire was completed by the patients at 1 year follow scored from 1-5 where 5 was very satisfied. STATA Release 13 was used for statistical analysis. T-test, Mann-Whitney U test and Pearson correlation were used.
RESULTS:
218 patients had complete data and completed the study at follow up. The patient characteristics are summarized in Table 1. Complications occurred in 6.25% of patients: 3.8% had infection and explantation, 0.9% had a superficial infection with successful conservative management, 0.9% had an erosion (one patient with associated infection) and 0.9% had mechanical failure (one patient with associated infection). The difference in HbA1c and FBS in patient with unremarkable postoperative course (HbA1c 7.9; FBS 152) or those with infective complications (HbA1c 8.6; FBS 183) did not reach statistical significance (p=0.06 and p=0.07, respectively). The correlation between day of surgery FBS and HbA1c was weak (r=0.281; r2=0.0795). Day of surgery FBS was within a 20 mg/dl range with what was expected based on HbA1c measurement in 62 patients (30%). The disparity between day of surgery FBS and expected FBS based on HbA1c was greater than 20 mg/dl in 146 (70%) patients.
CONCLUSIONS:
Day of surgery FBS is only weakly correlated with HbA1c and did not predict the outcome of PPS.
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