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Risk factors for penile prosthesis infection: An umbrella review and meta-analysis
Konstantin Menshchikov1, Mikhail Menshchikov1, Dmitry Yurasov1
1The Russian Medical Academy for Continuing Professional Education (RMANPO), Moscow, Russia.
Background:
As available data on implantation-related infections is contradictory, the aim was to identify the predictors of penile prosthesis infection.
Methods:
We performed an umbrella review and meta-analysis including systematic reviews with extractable data. Literature search was done in two databases: PubMed and Google Scholar. The participants were males with erectile dysfunction regardless of etiology who underwent penile implant surgery. Using a standardized form, three trained researchers reviewed each reference (systematic review) by title and abstract. The meta-analysis was performed using Review Manager 5.4.1 (RevMan® 5.4.1).
Results:
A total of 78 systematic reviews were identified with the search strategies. Of these, 35 duplicates were removed. Thirty-seven full-text reviews were then excluded after revision. Six systematic reviews with a total of 271,226 patients (156,553 patients in the study group and 114,673 patients in the control group) were included in the meta-analysis. The analysis identified various predictors of adverse outcomes (infection). Among them were glycated hemoglobin (HbA1c) and different characteristics of penile implants.
Conclusions:
The systematic review and meta-analysis revealed significant risk factors/predictors of penile prosthesis infection: glycated hemoglobin levels; reoperation, and two predictors associated with the type of penile prosthesis. The weighted mean HbA1c levels of patients with and without infections were 8.37% and 7.17% respectively. The OR was as follows: first surgery/revision OR 0.36 (95% CI 0.29-0.45); antibiotic-coated/non-coated prosthesis OR 0.47 (95% CI 0.31-0.72); malleable/inflatable prosthesis OR 3.51 (95% CI 1.41-8.74).
Insights
Penile prosthesis infection risk is linked to elevated glycated hemoglobin (HbA1c) and implant type. Higher HbA1c and inflatable prostheses increase infection risk, while antibiotic coatings may reduce it.
Area of Science:
- Urology
- Surgical Infections
- Medical Device Research
Background:
- Implantation-related infections following penile prosthesis surgery present conflicting data.
- Identifying reliable predictors for penile prosthesis infection is crucial for patient outcomes.
Purpose of the Study:
- To conduct an umbrella review and meta-analysis to identify predictors of penile prosthesis infection.
- To resolve contradictions in existing data regarding infection risk factors.
Main Methods:
- Umbrella review and meta-analysis of systematic reviews with extractable data.
- Literature search performed in PubMed and Google Scholar databases.
- Inclusion of males undergoing penile implant surgery for erectile dysfunction.
Main Results:
- Six systematic reviews with 271,226 patients were included.
- Key predictors identified include glycated hemoglobin (HbA1c) levels and penile implant characteristics.
- Elevated HbA1c (8.37% vs 7.17%) was associated with higher infection rates.
Conclusions:
- Significant risk factors for penile prosthesis infection include elevated HbA1c, reoperation, and specific prosthesis types.
- Inflatable prostheses showed a higher risk (OR 3.51) compared to malleable ones.
- Antibiotic-coated prostheses demonstrated a reduced risk (OR 0.47) compared to non-coated ones.
