Early penile prosthesis infections in the contemporary antimicrobial era: Incidence and predictive factors from a regional cohort

Abstract Objectives To evaluate the incidence and predictive factors of early penile prosthesis (PP) infection within a contemporary regional cohort in the North of England. Patients and methods A retrospective review of all PP implantations was conducted at a tertiary urology and andrology centre between 2018 and 2025, with variables including age, BMI, smoking, relevant comorbidities, pre‐operative HbA1C, immunosuppressant use and device‐related variables. Data were analysed using SPSS v29, with univariate logistic regression performed to identify factors of early infection (≤30 days). A p ‐value < 0.05 was considered statistically significant. Results A total of 103 patients underwent PP implantations. Mean age at implant was 59.4 ± 9.9 years. The comorbidity burden of diabetes, hypertension and dyslipidaemia was 35.0%, 49.5% and 39.8%, respectively, with mean pre‐operative HbA1C at 45.6 mmol/mol. Notably, 9.7% of patients were on chronic immunosuppressive therapy. Early prosthetic infection was identified in six patients (5.8%). On univariate analysis, there was a strong association between immunosuppressant use and infection (50.0% vs 7.2%, p = 0.02; OR 12.0, 95% CI 1.7–85.0). The variables of age, BMI, diabetes, hypertension, dyslipidaemia, HbA1C and implant type were not associated with infection. Conclusion In this contemporary regional study, early PP infection was identified in 5.8% of the cohort, with chronic immunosuppressant use being the dominant predictor of infection. Other metabolic, clinical and implant factors were not predictive of infection. This demonstrates immunosuppression being a persistent biological vulnerability requiring risk stratification and targeted perioperative strategies. Larger, prospective multicentre studies are required to further validate its impact and inform evidence‐based infection‐prevention protocols.