TY - JOUR
T1 - Penile prosthesis infection and diabetes mellitus
T2 - a systematic review and meta-analysis
AU - Corona, Giovanni
AU - Capogrosso, Paolo
AU - Lee, Wai Gin
AU - Osmonov, Daniar
AU - van Renterghem, Koenraad
AU - Otero, Javier Romero
AU - Ward, Sam
AU - Salonia, Andrea
AU - Reisman, Yacow
AU - Bettocchi, Carlo
AU - Maggi, Mario
AU - Fode, Mikkel
N1 - © The Author(s) 2026. Published by Oxford University Press on behalf of The International Society for Sexual Medicine. All rights reserved. For commercial re-use, please contact [email protected] for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact [email protected].
PY - 2026/1/5
Y1 - 2026/1/5
N2 - BACKGROUND: The preoperative glycemic control of diabetic patients may increase the risk of penile prosthesis (PP) infection, but the published literature remains controversial.AIM: To systematically review and meta-analyze available evidence on the impact of diabetes mellitus (DM) and glycemic control on PP infection. The study was completed under the auspices of the European Society for Sexual Medicine Surgical Academy.METHODS: An comprehensive Medline, Embase, and Cochrane search was performed including the keywords: ("penile prosthesis" and "diabetes mellitus"). Only English-language articles published between January 1, 1969 and May 31, 2024 were included.OUTCOMES: The primary outcome measure was the risk of PP infection in diabetic patients. The secondary outcome measure was the contribution of glycemic control on PP infection rate.RESULTS: Out of 182 retrieved articles, 11 were included in the study, summarizing 10 024 subjects with a mean age of 59.7 years, and a mean follow-up of 37.2 months. Overall, a PP infection rate of 4.3[3.9-4.8]% was observed. The PP infection rate increased according to baseline HbA1c levels, and the latter result was confirmed following adjustment for age and trial duration (P < .0001). Accordingly, PP infection rate was more than 2-times higher when trials with a mean HbA1c ≥ 8% were compared to the rest of the sample (9.1[7.5;11.0] vs 3.8[3.2;4.5]%; Q = 43.18; P < .0001).CLINICAL IMPLICATIONS: Optimization of the preoperative glycemic control may reduce PP infection rate in diabetic patients.STRENGTHS AND LIMITATIONS: The present study provides evidence supporting a significant increased risk of PP infection for patients with DM and pre-operative HbA1c ≥ 8%. Analysis was primarily derived from retrospective studies, which represent a significant source of bias. The exclusion of those studies including less than 70% of diabetic patients can represent a further source of bias.CONCLUSION: The present study shows a significant association between pre-operative HbA1c and PP infection rate. Further studies are advisable in order to better clarify the best threshold of HbA1c that is acceptable prior to implant surgery in diabetic patients.
AB - BACKGROUND: The preoperative glycemic control of diabetic patients may increase the risk of penile prosthesis (PP) infection, but the published literature remains controversial.AIM: To systematically review and meta-analyze available evidence on the impact of diabetes mellitus (DM) and glycemic control on PP infection. The study was completed under the auspices of the European Society for Sexual Medicine Surgical Academy.METHODS: An comprehensive Medline, Embase, and Cochrane search was performed including the keywords: ("penile prosthesis" and "diabetes mellitus"). Only English-language articles published between January 1, 1969 and May 31, 2024 were included.OUTCOMES: The primary outcome measure was the risk of PP infection in diabetic patients. The secondary outcome measure was the contribution of glycemic control on PP infection rate.RESULTS: Out of 182 retrieved articles, 11 were included in the study, summarizing 10 024 subjects with a mean age of 59.7 years, and a mean follow-up of 37.2 months. Overall, a PP infection rate of 4.3[3.9-4.8]% was observed. The PP infection rate increased according to baseline HbA1c levels, and the latter result was confirmed following adjustment for age and trial duration (P < .0001). Accordingly, PP infection rate was more than 2-times higher when trials with a mean HbA1c ≥ 8% were compared to the rest of the sample (9.1[7.5;11.0] vs 3.8[3.2;4.5]%; Q = 43.18; P < .0001).CLINICAL IMPLICATIONS: Optimization of the preoperative glycemic control may reduce PP infection rate in diabetic patients.STRENGTHS AND LIMITATIONS: The present study provides evidence supporting a significant increased risk of PP infection for patients with DM and pre-operative HbA1c ≥ 8%. Analysis was primarily derived from retrospective studies, which represent a significant source of bias. The exclusion of those studies including less than 70% of diabetic patients can represent a further source of bias.CONCLUSION: The present study shows a significant association between pre-operative HbA1c and PP infection rate. Further studies are advisable in order to better clarify the best threshold of HbA1c that is acceptable prior to implant surgery in diabetic patients.
KW - Humans
KW - Male
KW - Penile Prosthesis/adverse effects
KW - Prosthesis-Related Infections/epidemiology
KW - Glycated Hemoglobin/analysis
KW - Diabetes Mellitus
KW - Glycemic Control
KW - Diabetes Complications
KW - Risk Factors
KW - Middle Aged
KW - infection
KW - diabetes mellitus
KW - erectile dysfunction
KW - penile implants
KW - penile prosthesis
UR - http://www.scopus.com/inward/record.url?scp=105026638822&partnerID=8YFLogxK
U2 - 10.1093/jsxmed/qdaf340
DO - 10.1093/jsxmed/qdaf340
M3 - Review
C2 - 41489200
SN - 1743-6095
VL - 23
JO - The journal of sexual medicine
JF - The journal of sexual medicine
IS - 1
M1 - qdaf340
ER -