(700) Patient Satisfaction and Outcomes Following the Insertion of a Penile Prosthesis in Men Aged ≥ 75

Abstract Introduction Penile implant surgery represents an established treatment option for men with refractory erectile dysfunction. In the ageing population the balance of surgical risks with patient benefits are paramount. Objective To evaluate outcomes and satisfaction following primary penile prosthesis (PP) implantation in men aged ≥75 years, treated at a high-volume andrology centre in the United Kingdom. Methods Patients who underwent PP surgery between January 2020 and January 2025 and were aged ≥75 years at the time of operation were included. Electronic records were reviewed to collect demographic, perioperative, and postoperative data. All patients were assessed postoperatively by both a specialist nurse and a clinician, with satisfaction recorded at a minimum of six months. A total of 48 patients met the inclusion criteria. Results A total of 48 patients underwent penile prosthesis (PP) surgery during the study period, comprising 30 primary insertions and 18 revision procedures. The mean age was 77 years (range 75–84), with a mean follow-up of 36 months (6–64). Of the cohort, 21 (70%) received an inflatable three-piece PP and 9 (30%) a malleable PP. The aetiology of erectile dysfunction included metabolic syndrome in 12 patients (40%), post-prostatectomy in 8 (27%), diabetes in 6 (20%), Peyronie's disease in 2 (7%), priapism in 1 (3%), and post-TURP in 1 (3%). Four patients (8%) had received prior pelvic EBRT for prostate cancer. Median ASA grade was 3 (range 1–3). Median length of stay was two nights (range 1–6). One patient (3%) failed TWOC postoperatively. There was one readmission (3%) within 30 days due to infection, resulting in prosthesis removal (Clavien-Dindo 3b). A correlation was noted between re-catheterisation for failed TWOC and early infection. There were no other readmissions within 30 or 90 days. Three patients (10%) required subsequent revision surgery for autoinflation, faulty pump and a perceived lack of rigidity of a malleable PP. Overall satisfaction was high at 93% (27/29). Two patients (4%) reported dissatisfaction due to perceived lack of rigidity. Three deaths (10%) were recorded, all occurring more than 36 months post-PP surgery and deemed unrelated to the index operation. Conclusions This represents one of the few contemporary UK series evaluating PP outcomes in elderly men. Penile prosthesis implantation in men aged ≥75 years demonstrated excellent satisfaction and functional outcomes with low complication and revision rates. These findings support the safety and efficacy of PP surgery in appropriately selected older patients. Disclosure No