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Is the infrapubic approach a safe option for patients with poorly controlled diabetes mellitus and obesity undergoing inflatable penile prosthesis surgery?

Title: Is the infrapubic approach a safe option for patients with poorly controlled diabetes mellitus and obesity undergoing inflatable penile prosthesis surgery?
Authors: Micallef, Dariush; Wightman, Stuart; Naqi, Muhammad; Modgil, Vaibhav; Pearce, Ian
Source: Journal of Clinical Urology ; volume 18, issue 1, page 61-68 ; ISSN 2051-4158 2051-4166
Publisher Information: SAGE Publications
Publication Year: 2022
Description: Objective: Inflatable penile prosthesis (IPP) surgery is an effective treatment for patients with erectile dysfunction (ED). The two most used surgical approaches are infrapubic (IP) and penoscrotal (PS). Concerns exist whether raised Body Mass Index (BMI) or poor glycaemic control negatively affect outcome. We conducted a retrospective review of 50 consecutive virgin IP IPP cases investigating the effect of BMI and glycaemic control on post-operative complications and implant utilisation. Patients and Methods: Data collected included demographics, ED aetiology and risk factors, diabetic status, HbA1c and post-operative complications focusing on infection and re-operation. Telephone survey provided implant usage at 3, 6, 12 and 24 months post-operatively. All patients followed the same pre-, peri- and post-operative pathway, including antibiotic prophylaxis and implant preparation. Results: Complication rates of patients with BMI ⩾ 30 (2/20; 10%) and BMI < 30 (0/28, 0%) ( p=0.169) and of patients with poorly controlled diabetes mellitus (DM), HbA1c > 69 mmol/mol (0/6, 0%) versus HbA1c ⩽ 69 (2/21, 9.52%) ( p = 1) were not significantly different. Two patients reported complications. Implant utilisation did not differ significantly between low or high BMI and HbA1c cohorts. Conclusion: Our study shows pre-operative HbA1c and BMI do not significantly impact complication rates or implant utilisation in patients undergoing IP IPP insertion. Level of Evidence: 2b
Document Type: article in journal/newspaper
Language: English
DOI: 10.1177/20514158221136351
Availability: https://doi.org/10.1177/20514158221136351; https://journals.sagepub.com/doi/pdf/10.1177/20514158221136351; https://journals.sagepub.com/doi/full-xml/10.1177/20514158221136351
Rights: https://journals.sagepub.com/page/policies/text-and-data-mining-license
Accession Number: edsbas.595FD260
Database: BASE