Previous pelvic radiation therapy is the single strongest risk factor for penile prosthesis infection. Data from a large monocentric series
Ceruti, C1; Sibona, M1; Preto, M1; Bertinato, R1; Sedigh, O2; Timpano, M2; Falcone, M1; Gontero, P1; Rolle, L1
1: University of Turin, Italy; 2: Città della Salute e della Scienza di Torino
Objectives: Infection is the worst complication of prosthetic surgery, as a simple procedure or associated with adjunctive maneuvers; aim of the study is to assess risk factors for infections in a large monocentric series.
Materials and Methods: We revised data of 395 pt who underwent penile prosthetic surgery from 10/2004 to 1/2017. 276 pt had a hydraulic implant, 119 non hydraulic; in 308 pt we performed a simple prosthetic procedure, in 87 a complex surgical procedure In 128 pt the main diagnosis resulted vasculogenic ED, in 143 PD with important deformities, in 124 ED post pelvic radical surgery; in the latter group, 29 patients underwent also radiotherapy before prosthetic surgery.
Statistical analisys: exact Fisher’s test, chi-square test, mono and multi-variate logistic regression.
Results: Global infection rate was 3.8%; no statistical significant correlations were registered between infection rate and adjunctive surgical maneuvers (p=0.75) or model of the prosthesis implanted (p=0.77). Infection rate resulted 3/128 (2.3%) in vasculogenic ED pt, 3/143 (2.1%) in PD pt, 124 (7.2%) in post pelvic surgery pt. In particular, infection rate was 4/95 (4.2%) in pt who underwent only pelvic surgery and 5/29 (17%) in pt who underwent both procedures. Correlation with pelvic surgery alone didn’t reached significance (p=0.2), whereas both monovariate (Fisher; p=0.03) and multivariate logistic regression (O.R. 4.7, p=0.028) revealed a strong correlation between infection and previous radiotherapy. No statistical correlations were registered between infection and age, diabetes, coronary artery disease, hypertension, smoke.
Discussions and Conclusions: The single strongest risk factor associated with prosthetic infection is previous pelvic radiation therapy, that increases by 4.7 fold the risk. No statistical significant correlations were found between infection and parameters such complexity of surgery or diabetes (perhaps because only pt in excellent compensation were admitted to surgery) . These data define a new profile of high risk patient for prosthetic surgery.
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