Would you proceed with penile prosthesis placement in a patient with a HbA1c of 9.5% based on recent literature finding that elevated HbA1c is not necessarily predictive of increased infection rates?

I like to look at trends for HbA1C levels. If a man signed up for IPP and his A1C was 7.8 and a week before surgery it was 9.5, I’m going to encourage him to work on reducing that level. If a man comes to me with a 13.8 and he works so hard to get it to 9.5, that’s a different guy. I see A1C as a bi...

This is very much surgeon dependent. Many surgeons have A1C cut-offs which can vary significantly. The data does not support higher infection rates in Diabetics as you noted, however the theoretical risk often makes surgeons cautious. I do not have a specific cut-off rather make a patient specific d...

I would not. Although the literature is conflicting, large database and meta-analytic studies support higher infection risk with elevated preoperative HbA1c, while several high-volume multicenter studies show no predictive value. The signal is strongest at the extremes of poor control (~>8.5–10%), w...