Abstract Introduction Penile prosthesis (PP) implantation is one treatment option for erectile dysfunction, yet infection continues to pose a major postoperative concern due to the subsequent physiological and economic burden. In the modern antimicrobial era, characterised by coated implants, refined surgical technique, and optimised perioperative antibiotic use, reported infection rates have declined substantially. However, device infection still occurs, suggesting persistent patient- or procedure-related determinants. Objective This study evaluates the incidence and predictive factors of early PP infection within a contemporary regional centre’s cohort covering the geographically vast North of England. Methods A retrospective review was conducted of all penile prosthesis insertions performed at our regional centre between 2018 and 2025. Baseline characteristics of interest included age, body mass index (BMI), comorbidities (diabetes, hypertension, dyslipidaemia, ischaemic heart disease, steroid use, Peyronie’s disease, post-radical prostatectomy, pelvic radiotherapy), smoking status, type and brand of implant, and pre-operative HbA1c level. An infection was defined as one that occurred within 30 days of prothesis insertion and involved either the implant or wound. Data were collated in Microsoft Excel and analysed using SPSS v29. Descriptive and univariate logistic regression analyses were performed to identify factors associated with early infection (≤30 days). A p-value 0.05 was considered statistically significant. Results A total of 103 patients were included, with a mean age of 59.4 ± 9.9 years and mean BMI of 29.7 ± 4.7 kg/m2. Most underwent inflatable PP insertion (79.6%), while 20.4% received malleable implants. Diabetes was present in 35.0%, hypertension in 49.5%, and dyslipidaemia in 39.8% of patients; 9.7% were on immunosuppressive medications. HbA1c data were available for 91 patients, with a mean of 45.6 ± 12.3 mmol/mol. Within 30 days, 6 patients (5.8%) developed an infection. Infected and non-infected groups were comparable in age (59.5 ± 8.4 vs 59.4 ± 10.0 years), BMI (29.5 ± 2.7 vs 29.7 ± 4.8 kg/m2), and HbA1c (46.6 ± 11.4 vs 45.5 ± 12.4 mmol/mol). Rates of diabetes (33.3% vs 35.1%), hypertension (33.3% vs 50.5%), and dyslipidaemia (33.3% vs 40.2%) did not differ significantly. On univariate logistic regression, immunosuppressant use was significantly associated with infection (50.0% vs 7.2%, p = 0.02; OR 12.0, 95% CI 1.7–85.0). No significant associations were identified for age, BMI, HbA1c, diabetes, or implant type (p 0.05). Conclusions Data from our regional centre demonstrated that early penile prosthesis infection occurred in 5.8% of patients. Immunosuppressive therapy was independently associated with an increased risk of infection, whereas other clinical and metabolic parameters showed no significant effect. These findings identify immunosuppression as a risk factor warranting tailored perioperative strategies and highlight the need for larger, multicentre studies to validate its impact on postoperative infection outcomes. Disclosure No
Mubarak et al. (Mon,) studied this question.