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Risky business: penile prosthesis in high-risk patients.

Sukhjeevan S Nijhar1, Charlotte C Goldman2, Joanna Orzel1

  • 1School of Medicine, Georgetown University, Washington, DC, USA.

Translational Andrology and Urology
|October 24, 2025
PubMed
Summary

Diabetic patients undergoing penile prosthesis surgery did not experience higher complication rates. Peri-operative hyperglycemia and high HbA1c levels were not linked to increased risks of device infection, erosion, or malfunction.

Keywords:
Penile prosthesisdiabeteshyperglycemiaimmunocompromisedtransplant

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Area of Science:

  • Urology
  • Medical Device Technology
  • Endocrinology

Background:

  • Patients with diabetes and immunocompromising conditions may face increased penile prosthesis risks.
  • Limited and contradictory data exists for this high-risk population.
  • This study reviews outcomes in high-risk patients at a tertiary-care center.

Purpose of the Study:

  • To investigate the association between peri-operative hyperglycemia and penile prosthesis complications.
  • To determine if elevated glycosylated hemoglobin (HbA1c) levels increase the risk of device infection, erosion, or malfunction.

Main Methods:

  • Retrospective review of 235 penile prosthesis insertions (2012-2023).
  • Collected peri-operative HbA1c, mean, and maximum blood glucose levels.
  • Primary outcome: device infection requiring reoperation; secondary outcomes: erosion, malfunction.

Main Results:

  • No significant difference in reoperation rates for device infection between diabetic (2.8%) and non-diabetic (3.4%) patients.
  • Peri-operative HbA1c and blood glucose levels were higher in diabetic patients.
  • No increased prosthetic complication rates were observed at HbA1c cutoffs of 8.5 or 10 g/dL.

Conclusions:

  • Diabetic patients did not experience higher rates of device-related complications after penile prosthesis surgery.
  • No association found between preoperative HbA1c levels (8.5 or 10 g/dL) and increased prosthetic complications.
  • Peri-operative hyperglycemia does not appear to elevate the risk of penile prosthesis complications in this cohort.