(828) Penile Prosthesis Implantation: Complication Spectrum and Clinical Outcomes in a Single Centre Cohort

Abstract Introduction Penile prosthesis implantation (PPI) restores sexual function with durable efficacy and high satisfaction for men with refractory erectile dysfunction. Contemporary pathways combining coated devices, infection-mitigation bundles, and meticulous corporal technique have progressively reduced infectious and mechanical failures. Nevertheless, clinically relevant complications persist, including infection, erosion/extrusion, mechanical malfunction, corporal or urethral injury, hematoma/seroma, reservoir-related events, chronic pain, and dissatisfaction with length or cosmesis. Real-world series remain essential to refine peri-operative protocols, counselling, and follow-up. Objective To evaluate clinical outcomes, complication patterns, and patient-reported satisfaction following contemporary PPI, including the performance of dual implantation in men with concomitant stress urinary incontinence. Methods We conducted a single center retrospective review of 250 consecutive PPIs. Collected variables included indications, device selection, operative details, peri-operative infection-prevention measures, early and late complications, revision events, and patient-reported satisfaction. Complex cases receiving dual implants (artificial urinary sphincter AUS with PPI) were captured. Outcomes were interpreted against contemporary reference ranges from the peer-reviewed literature. Results Peri-operative care incorporated a standardized infection-reduction bundle with careful corporal dilation, hemostasis, and device sizing. Infection emerged as the most frequent complication in this cohort; however, its incidence remained low for modern PPI practice. Other adverse events were observed across the recognized spectrum erosion/extrusion, mechanical malfunction requiring revision, hematoma/seroma, and infrequent urethral injury rates. Reservoir-related events were uncommon. Eight patients underwent dual implantation of artificial urinary sphincters (AUS) and Penile Prosthesis Implantation (PPI) for combined erectile dysfunction and stress urinary incontinence following open prostatectomy; many were late presentations or referrals. Patterns suggested improved continence outcomes among men treated with robotic prostatectomy compared with historical open procedures. Patient-reported satisfaction was high overall, supported by device reliability, expectation-aligned counselling, and structured follow-up. Conclusions n this contemporary 250-case single-center experience, protocolized PPI achieved favorable safety, robust functional recovery, and high satisfaction. While infection was the predominant complication, it remained infrequent and aligned with modern low rates, reinforcing the value of bundled infection-prevention strategies and meticulous techniques. Outcomes in complex scenarios, including dual implantation, were acceptable, underscoring the importance of multidisciplinary selection, targeted counselling, and standardized aftercare. These findings support PPI as an effective solution for appropriately selected patients and highlight actionable opportunities to further minimize infectious risk and streamline rehabilitative pathways particularly for men requiring combined continence and erectile restoration. Disclosure No