Infection rate of penile prosthesis implants in men with spinal cord injury: a meta-analysis of available evidence

The risk of penile prosthesis implants (PPIs) infection in men with spinal cord injury (SCI), empirically theorized to be high, is widely variable among the studies. We performed a meta-analysis to define the pooled PPI infection rate and its possible risk factors in men with SCI. A thorough search...

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Bibliographic Details
Published inInternational journal of impotence research Vol. 36; no. 3; pp. 206 - 213
Main Authors Tienforti, Daniele, Totaro, Maria, Spagnolo, Luca, Di Giulio, Francesca, Castellini, Chiara, Felzani, Giorgio, Baroni, Marco Giorgio, Francavilla, Sandro, Barbonetti, Arcangelo
Format Journal Article
LanguageEnglish
Published London Nature Publishing Group UK 01.05.2024
Nature Publishing Group
Subjects
692/499
692/700/565/545
Infections
Medicine
Medicine & Public Health
Penis
Prostheses
Reproductive Medicine
rology
Spinal cord injuries
Urology
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Summary:The risk of penile prosthesis implants (PPIs) infection in men with spinal cord injury (SCI), empirically theorized to be high, is widely variable among the studies. We performed a meta-analysis to define the pooled PPI infection rate and its possible risk factors in men with SCI. A thorough search of PubMed, Scopus and Web of Science was performed. The eighteen included studies provided information on 1079 implantation procedures, determining a pooled PPI infection rate of 8.0% (95% CI: 5.0–11.0%), with significant heterogeneity (I² = 67.0%). Trim-and-fill adjustment for publication bias had a small effect on the pooled estimate (adjusted odds ratio: 6.3%, 95% CI: 2.5–10.0%) with a substantial reduction in heterogeneity (I 2  = 32.4%). The PPI infection rate was higher for inflatable PPIs than for malleable PPIs (16.4% vs 8.9%, p  = 0.027). No differences were found between the different levels of SCI. In conclusion, the risk of PPI infection in SCI would be higher than that reported in the general population. However, the results were produced from dated and low/moderate quality studies that may not fully reflect the outcomes of modern PPIs and implantation protocols. There is an urgent need to gather more information on this topic through studies relevant to contemporary practice.
ISSN:0955-9930
1476-5489
DOI:10.1038/s41443-022-00632-x