Immediate preoperative blood glucose and hemoglobin a1c levels are not predictive of postoperative infections in diabetic men undergoing penile prosthesis placement

Osman, Mohamad M.; Huynh, Linda; El‐Khatib, Farouk M.; Towe, Maxwell; Su, Heng; Andrianne, Robert; Barton, Gregory J.; Broderick, Gregory A.; Burnett, Arthur L.; Campbell, Jeffrey; Clavell-Hernández, Jonathan; Connor, Jessica; Gross, Martin; Guillum, Ross; Guise, Amy I.; Hatzichristodoulou, Georgios; Henry, Gerard D.; Hsieh, Tung-Chin; Jenkins, Lawrence C.; Koprowski, Christopher; Lee, Kook B.; Lentz, Aaron; Munárriz, Ricardo; Pan, S. H.; Parikh, Kevin; Park, Sung Hun; Patel, A; Perito, Paul; Sadeghi‐Nejad, Hossein; Sempels, Maxime; Simhan, Jay; Wang, Run; Yafi, Faysal A.

doi:10.1038/s41443-020-0261-5

Cited by 13 publications

(7 citation statements)

References 29 publications

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“…They did not find any correlation between preoperative blood glucose levels or HbA1c levels and postoperative infection rates: p = 0.220 and p = 0.598, respectively. The same group on multivariate analysis found that a history of diabetes-related complication was a significant predictor of higher revision rates (p = 0.034), but was nonsignificant for infection or explantation rates [18].…”

Section: Discussionmentioning

confidence: 93%

“…Many papers were published investigating the correlation between DM and risk of penile implant infection but most of them compared diabetics with non-diabetics [6,9,11,12,15]. Few available data compared controlled diabetics with non-controlled using HbA1c [8,13,16] and only one recent paper investigated blood glucose level before surgery [18].…”

Section: Introductionmentioning

confidence: 99%

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Correlation of fasting blood sugar at the time of penile prosthesis surgery with the level of glycated hemoglobin and the outcome of surgery

et al. 2021

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Background The role of glycemic control in predicting implant infection and other surgical complications is debatable. This study aimed to assess the potential correlation between fasting blood sugar (FBS) levels prior to penile prosthesis surgery (PPS) and the surgical outcomes. Methods A retrospective study from data collected prospectively in 2015 in a single center. Patients who underwent penile implant procedures were included. Exclusion criteria were if surgery done by low-volume implanter, patients who required revision surgery or not diagnosed with diabetes mellitus. Management was standardized to all patients. Results All complications whether minor or major were documented up to three years. One year after the surgery a Likert scale questionnaire was completed by the patients. In total, 218 patients completed the study at last follow-up. Complications rate was 6.25%. The rate of infection requiring explantation was 3.8%. 0.9% of patients had a superficial infection managed successfully with conservative management. 0.9% had erosion and 0.9% had mechanical failure. There was no statistically significant difference in FBS or glycated hemoglobin (HbA1c) levels in patients with postoperative complications compared to patients with satisfactory postoperative course. FBS level on the day of surgery was within 20 mg/dL (1.11 mmol/L) of the expected range based on HbA1c measurement in 62 patients (28.44%), while in 146 patients (66.98%) the FBS was not within 20 mg/dl (1.11 mmol/L) of the expected range based on preoperative HbA1c level. Conclusion FBS levels on the day of surgery are not correlated with HbA1c levels and PPS outcomes.

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Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Correlation of fasting blood sugar at the time of penile prosthesis surgery with the level of glycated hemoglobin and the outcome of surgery

et al. 2021

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“…This study did admit that the risk of infection in diabetics was higher but HbA1c and FBS was not predictive (Wilson et al., 1998). Furthermore, in a multi‐centre retrospective analysis of 875 diabetic patients undergoing primary PPI, pre‐operative HbA1c and blood glucose levels within 6 hr of surgery were not associated with post‐operative infection, revision, or explanation (Osman et al., 2020). In the previous study conducted in Hamad Medical Corporation (Canguven et al., 2018) together with the current report, no direct correlation between elevated HbA1c and PPI infection is shown.…”

Section: Discussionmentioning

confidence: 99%

HbA1c over 8.5% is not predictive of increased infection rate following penile prosthesis implant surgery in diabetic patients with erectile dysfunction

et al. 2021

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Diabetes mellitus is associated with increased risk of erectile dysfunction. Penile prosthesis implantation is an efficient therapeutic option for erectile dysfunction, but not without risk, as infection remains a prominent concern. This study investigates diabetes mellitus as a risk factor for penile prosthesis implantation infection and the relationship between haemoglobinA1c levels and infection rates. All diabetic patients with erectile dysfunction who underwent penile prosthesis implantation surgery between January 2012 and November 2019 at Hamad Medical Corporation, Qatar, were included in this retrospective observational study. A total of 599 diabetic patients with erectile dysfunction had penile prosthesis implantation. Mean age was 59.69 ± 31.19. Penile prosthesis implantation infection rate was 0.83% (5/599), while the mean haemoglobinA1c level was 7.58 ± 1.45 mmol/l (range: 4.1–12.6). A comparison between diabetic patients with penile prosthesis implantation infection and those without infection revealed no significant difference in the level of haemoglobinA1c between the two groups with mean haemoglobinA1c in patients with infected implants 7.14 and 7.59 for noninfected (p = 0.491). Limitations include retrospective single‐centre design and low‐infection rates reducing sample number. Penile prosthesis implantation infection rate in a large series of diabetic patients was low with no significant association between haemoglobinA1c level and penile prosthesis implantation infection observed.

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“…A total of 172,107 patients were included in the 30 studies (3690 in the prospective studies and 168,417 in the retrospective studies). Of these, 21 studies (21/30, 70%) did not find a correlation between preoperative HbA1c levels and increased incidence of postoperative SSI 17–19,21–24,26,27,29,30,34,35,37,38,40,41,43–46 . One study did find that HbA1c levels greater than 11.5% had increased risk of SSI, 42 while the other eight publications showing a positive correlation between HbA1c and SSI risk discussed HbA1c levels in the 7%–8% range 20,25,28,31–33,36,39 .…”

Section: Literature Reviewmentioning

confidence: 98%

“…Results were categorized by type of surgery, if provided. A total of 30 studies were included in the review 17–46 of which five were prospective and 25 were retrospective. A total of 172,107 patients were included in the 30 studies (3690 in the prospective studies and 168,417 in the retrospective studies).…”

Section: Literature Reviewmentioning

confidence: 99%

Preoperative hemoglobin A1c and perioperative blood glucose in patients with diabetes mellitus undergoing spinal cord stimulation surgery: A literature review of surgical site infection risk

Hagedorn¹,

Hoelzer

Aiyer³

et al. 2022

Pain Practice

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Aims The aim of our study was to review the surgical literature regarding the relationship between hemoglobin A1c (HbA1c), diagnosis of diabetes mellitus (DM), and risk of postoperative surgical site infection (SSI). Methods A librarian‐assisted literature search was performed with two goals: (1) identify surgical publications related to SSI and HbA1c values, and (2) identify publications reporting infection risk with DM in spinal cord stimulation (SCS), intrathecal drug delivery systems (IDDS), and cardiovascular implantable electronic device (CIED) implantation surgeries. Published guidelines on perioperative management of DM are reviewed. Results We identified 30 studies reporting SSI and HbA1c values. The literature review indicated that for many surgical procedures, elevated HbA1c is not correlated to rate of SSI. We identified 16 studies reporting infection rates within DM cohorts following SCS, IDDS, and CIED implantation surgeries. The data reviewed did not indicate DM as an independent risk factor for SSI. Conclusion Preoperative HbA1c levels in patients with a history of DM is not a singularly sufficient tool to estimate risk of perioperative infection in SCS implantation surgery. Published guidelines on perioperative management of DM do not suggest a specific HbA1c above which surgery should be delayed; intentional perioperative glycemic control is recommended.

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Immediate preoperative blood glucose and hemoglobin a1c levels are not predictive of postoperative infections in diabetic men undergoing penile prosthesis placement

Cited by 13 publications

References 29 publications

Correlation of fasting blood sugar at the time of penile prosthesis surgery with the level of glycated hemoglobin and the outcome of surgery

Correlation of fasting blood sugar at the time of penile prosthesis surgery with the level of glycated hemoglobin and the outcome of surgery

HbA1c over 8.5% is not predictive of increased infection rate following penile prosthesis implant surgery in diabetic patients with erectile dysfunction

Preoperative hemoglobin A1c and perioperative blood glucose in patients with diabetes mellitus undergoing spinal cord stimulation surgery: A literature review of surgical site infection risk

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