Correlation of fasting blood sugar at the time of penile prosthesis surgery with the level of glycated hemoglobin and the outcome of surgery

Abstract

Background: The role of glycemic control in predicting implant infection and other surgical complications is debatable. This study aimed to assess the potential correlation between fasting blood sugar (FBS) levels prior to penile prosthesis surgery (PPS) and the surgical outcomes. Methods: A retrospective study from data collected prospectively in 2015 in a single center. Patients who underwent penile implant procedures were included. Exclusion criteria were if surgery done by low-volume implanter, patients who required revision surgery or not diagnosed with diabetes mellitus. Management was standardized to all patients. Results: All complications whether minor or major were documented up to three years. One year after the surgery a Likert scale questionnaire was completed by the patients. In total, 218 patients completed the study at last follow-up. Complications rate was 6.25%. The rate of infection requiring explantation was 3.8%. 0.9% of patients had a superficial infection managed successfully with conservative management. 0.9% had erosion and 0.9% had mechanical failure. There was no statistically significant difference in FBS or glycated hemoglobin (HbA1c) levels in patients with postoperative complications compared to patients with satisfactory postoperative course. FBS level on the day of surgery was within 20 mg/dL (1.11 mmol/L) of the expected range based on HbA1c measurement in 62 patients (28.44%), while in 146 patients (66.98%) the FBS was not within 20 mg/dl (1.11 mmol/L) of the expected range based on preoperative HbA1c level. Conclusion: FBS levels on the day of surgery are not correlated with HbA1c levels and PPS outcomes.