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A CUT-OFF HBA1C VALUE OF 8.5% PREDICTS INCREASED RISK OF PENILE IMPLANT INFECTION

J UROLOGY • 2019
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Publication Information
Authors Mohamad Habous , Raanan Tal , Osama Abdelwahab , Osama Laban , Saad Mahmoud , Alaa Tealab , Saleh Binsaleh , and John Mulhall
Keywords Not Available
Journal J UROLOGY
Publisher Not Available
Volume Not Available
Issue Not Available
Pages Not Available
publication.type International
Paper Link Open Link
Supplementary Materials Not Available
Abstract
INTRODUCTION AND OBJECTIVES
Uncontrolled diabetes mellitus (DM) marked by elevated glycosylated hemoglobin A1c (HBA1c) values, has been correlated in some studies with an increased rate of infection after penile implant surgery. This study aimed to explore the association between HbA1C level and penile implant infection and to define if a cut-off value existed

METHODS
Between 2009-15 HbA1c levels were obtained on all patients undergoing penile implant surgery. Preoperative, perioperative and postoperative management was identical for the entire cohort. Univariate analysis was performed to define predictors of implant infection. HbA1c levels were analyzed as a continuous variable and sequential analysis was conducted utilizing 0.5% increments to define a cut-off level predicting implant infection. Multivariable analysis was performed with the following factors entered into the model: Diabetes yes/no; HbA1C level; patient age; implant type; vascular risk factor number; presence of PD; BMI and surgeon volume. A ROC curve was generated to define the optimal HbA1C cut-off for infection prediction

RESULTS
902 implant procedures have been performed over this period of time. The mean HbA1c level = 8 ± XX%, with 81% of men having HbA1c >6%. Mean age = 56.6 years. 685 (76%) implants were malleable, and 217 (24%) were inflatable. 302 (33.5%) patients had also a diagnosis of PD. Overall infection rate was 8.9% (80/902 subjects). Patients who had implant infection had significantly higher mean HbA1c levels, 9.5% vs 7.8% (p