Postoperative penile prosthesis pain: is it worse in diabetic patients?

ABSTRACT Inflatable penile prosthesis (IPP) surgery is an effective, safe and satisfactory treatment option for medication-refractory erectile dysfunction. Postoperative complications

include infection, mechanical failure, erosion, and pain. Current literature suggests the need for a better approach to postoperative pain management after IPP surgery. Clinical studies have

demonstrated that postoperative pain is different in diabetic patients. We sought to determine if there is a difference in pain after IPP placement in diabetics. This is a

single-institution retrospective review. The main outcome measure was the number of 30-day postoperative visits for pain. The secondary outcome included differences in how pain was managed.

The top HbA1c quartile was compared with the other HbA1c quartiles. Diabetes was present in 92 (54.4%) patients and 96% of these had HbA1c > 8. Significant postoperative pain was more

common in patients with HbA1c > 8 (41% vs 13%, _p_ = 0.047) and resulted in more unplanned visits (27% vs 11%, _p_ = 0.042). Patients with HbA1c > 8 with significant postoperative pain

were more likely to be managed with opioids and gabapentin (30% vs 14%, _p_ = 0.05). There were no statistical differences in age between diabetics and non-diabetics (mean 59 vs 61, _p_ = 

0.193). Hispanic and African-American patients represented 87% of the poorly controlled diabetics compared with only 13% of white patients (_p_ < 0.001). Poorly controlled diabetics had

more medical comorbidities (_p_ < 0.001). On logistic regression, a HbA1c > 8 was predictive of an unplanned visit for pain with an OR of 2.83 (_p_ = 0.04). Significant pain after IPP

surgery was higher in diabetics with HbA1c > 8, which resulted in more unplanned 30-day postoperative visits. Patients with significant postoperative pain were managed with a combination

of opioids and gabapentin. Future studies are required to optimize pain management in diabetics following IPP placement. Access through your institution Buy or subscribe This is a preview of

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mellitus and depression. J Med Life. 2016;9:120–5. PubMed  PubMed Central  Google Scholar  Download references AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Dartmouth-Hitchcock Medical

Center, New Hampshire, NH, USA Lael Reinstatler, Briana Goddard, Michael Rezaee & Martin Gross * Boston University School of Medicine, Boston, MA, USA Dayron Rodríguez, Michel Apoj &

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AUTHOR Correspondence to Ricardo Munarriz. ETHICS DECLARATIONS CONFLICT OF INTEREST Ricardo Munarriz and Martin Gross are consultants for Coloplast. ADDITIONAL INFORMATION PUBLISHER’S NOTE

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THIS ARTICLE Reinstatler, L., Rodríguez, D., Goddard, B. _et al._ Postoperative penile prosthesis pain: is it worse in diabetic patients?. _Int J Impot Res_ 33, 286–290 (2021).

https://doi.org/10.1038/s41443-020-0284-y Download citation * Received: 17 October 2019 * Revised: 08 January 2020 * Accepted: 08 April 2020 * Published: 23 April 2020 * Issue Date: April

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