(197) PENILE PROSTHESIS AND COMPLICATIONS: THE ROLE OF GLYCOSYLATED HEMOGLOBIN
Authors: Pereira De Souza AB , Tobias Junior T , Canettieri Rubez A , Fregonesi A , Destro Saad R , Franco De Oliveira Júnior F , Costa De Salles L , De Oliveira C , Chahade Sibanto Simões G , Degani Ottaiano A , Akel Ferruccio A , Massaro Junior VJ , Bernardes de Amaro L 
Published: December 2024

Abstract

Introduction
Erectile disfunction is a medical condition that affects man’s quality of life and mental health. Penile prosthesis implant is a valuable option when there is no response to conservator treatment, however this method is not free of complications, some can be severe, especially in diabetic patients.

Objectives
Analyze medical data from patients submitted to malleable penile prosthesis implant in a single center and correlate the level of glycosylated hemoglobin with postoperative complications.

Methods
It was conduced a retrospective analysis of medical records between August 2022 and May 2024 submitted to penile prosthesis implantation in a single center. It was analyzed patients age, diagnosis of diabetes, use of insulin, level of glycosylated hemoglobin (HbA1c) and recent (&lt;6 months) e late (&gt; 6 months) complications.

Results
We analyzed data from 30 patients submitted to malleable penile prosthesis implant from Promedon. In our center, patients with HbA1c less than 7,5% are eligible to surgery. It is prescribed antibiotics 24 h before, intra-operative and 24 h after surgery, and a 5-minute chlorhexidine scrub is performed before incision. All patients were dismissed with prescription of antibiotics during 7 to 14 days. The median age was 63,86 and median time of erectile disfunction is 6 years and 8 months. 40% of the patients had the diagnosis of diabetes and 27% were in use of insulin, the median HbA1C was of 6,13% varying from 5,2% to 7,5%, three patients did not have records of HbA1C. 80% of the patients had other comorbidities such as hypertension, chronic renal disease, dyslipidemia or were smokers. 40% (n = 12) had complications in the first 6 months after surgery and six of than had diabetes. Complications were described as dehiscence (50%), hematoma (16,67%), mobile prosthesis (16,67%), infection (8,34%) and seroma (8,34%), none had late complications. The patient with infection did not had diagnosis of diabetes, it was required hospitalization for intravenous antibiotic with no need of prosthesis removal or other complications after 6 months of follow-up. When evaluated patients with HbA1c between 5-5,9% (n = 14), 42,85% had complications, between 6-6,9% (n = 7), 42,85% had complications and &gt; 7% (n = 3), 14% had complications.

Conclusion
Infections related to penile prosthesis implant has decreased over the years, which can be associated with improvement of surgical techniques, prevention of bacterial colonization, use of antibiotic, however the association between diabetes and postoperative complications remain controversial. In our analysis, it was not possible to correlate diabetes or level of HbA1c with postoperative complications, since the groups with higher incidence of complications had HbA1c &lt; 6,9% and the patient with the most severe complication were not diabetic. Further prospective studies and statistical analyzes are necessary to determinate the correlation between diabetes and postoperative complications and the optimal level of HbA1c to reduce complications.

Disclosure
No.