Abstract Introduction Phalloplasty is crucial for transgender men seeking a functional neophallus with sufficient rigidity for sexual activity. Penile prosthesis implantation is fundamental, but its integration into neoformed tissue presents unique challenges. Scientific literature consistently reports complications such as extrusion and infection, which frequently require reintervention. Objective This study aimed to analyze the institutional experience in prosthesis placement during neophalloplasty, focusing on the incidence of postoperative complications and the subsequent need for secondary surgeries Methods A retrospective cohort study was conducted, analyzing clinical data from 23 patients who underwent transgender masculinizing phalloplasty with penile prosthesis placement between October 2015 and May 2025. One case of reimplantation by an external surgeon was excluded to ensure homogeneity. The variables of interest were: the need for prosthetic explantation due to complications, the current status of the prosthesis (functionality or absence), and the brand/model of the implant. Data collection was carried out through systematic review of clinical records. Results Twenty-three cases were analyzed. Eleven patients (47.8%) presented with postoperative complications, including mechanical failures, infectious events, and positional issues. To resolve these, all 11 affected patients (100% of complicated cases and 47.8% of the total) required one or more surgical reinterventions. Nevertheless, 17 of the 23 patients (73.9%) maintained a functional penile prosthesis at the time of analysis. Conclusions The findings of this study demonstrate a high complication rate (47.8%) in the implantation of penile prostheses during transgender masculinizing neophalloplasty. These consistently led to reinterventions (100% of the complicated cases). This morbidity aligns with the global scientific literature, which underscores the challenges of integrating prosthetic devices into a neophallus due to the complexity of the reconstruction. Despite the high incidence of reoperations, the 73.9% rate of current prosthetic functionality validates the clinical relevance of these interventions for the patients' quality of life. The need for exhaustive preoperative counseling and future research to optimize techniques, prevent infections, and develop more suitable prostheses is emphasized. Disclosure No
Belinky et al. (Mon,) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: