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Sodium-Glucose Transport Protein 2 Inhibitor Use Is Not Associated With Increased Risk of Inflatable Penile
Eric Wahlstedt1, Jessica Schardein2, John Wahlstedt3
1Thomas Jefferson Department of Urology, Philadelphia, PA.
Urology
|September 11, 2025
Summary
Diabetic patients using sodium-glucose transport protein 2 inhibitors (SGLT2i) do not face a significantly higher risk of inflatable penile prosthesis (IPP) infections. Lifestyle changes like smoking cessation and weight loss are more critical for reducing IPP infection risk.
Area of Science:
- Urology
- Endocrinology
- Medical Informatics
Background:
- Sodium-glucose transport protein 2 inhibitors (SGLT2i) are associated with increased genitourinary infections.
- Inflatable penile prosthesis (IPP) placement is a treatment option for erectile dysfunction in diabetic patients.
- The risk of IPP infection in diabetic patients using SGLT2i is not well-established.
Purpose of the Study:
- To investigate the association between SGLT2i use and the risk of IPP infections in diabetic patients.
- To determine the incidence of IPP infections in this patient population.
Main Methods:
- Retrospective review of diabetic men undergoing IPP placement from the IBM MarketScan database (2011-2021).
- Inclusion of demographic data (age, obesity, smoking status).
- Identification of IPP infections using ICD-9/10 and CPT codes.
- Multivariable analyses to assess the likelihood of IPP infections.
Main Results:
- A total of 2838 diabetic patients were analyzed; 31.1% used SGLT2i.
- The overall IPP infection rate was 2.9%, with 3.2% in the SGLT2i group and 2.8% in the non-SGLT2i group.
- SGLT2i use showed a non-significant increase in infection risk (HR 1.26, P = .39).
- Obesity (HR 2.02, P = .02) and smoking (HR 2.20, P < .01) were significant risk factors for IPP infection.
Conclusions:
- SGLT2i use does not appear to significantly increase the risk of IPP infections in diabetic patients.
- SGLT2i can likely be continued perioperatively in patients undergoing IPP placement.
- Smoking cessation and weight loss are recommended to reduce IPP infection risk in diabetic patients.
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