Abstract Introduction Psychogenic erectile dysfunction in younger men can be a cause for distress. Where penile implant surgery is an established treatment for refractory erectile dysfunction in patients with an established organic cause, further data can support its use in younger men with a predominant psychogenic picture. Objective To evaluate clinical outcomes and patient satisfaction following penile prosthesis implantation (PPI) in men aged ≤40 years with psychogenic erectile dysfunction. The study was conducted at a high-volume tertiary andrology centre in the United Kingdom. Methods Men aged ≤40 years who underwent penile prosthesis (PP) implantation between January 2020 and January 2025 were included. A total of 150 patients underwent PP surgery, accounting for 178 procedures. Postoperative assessment was performed by both a specialist nurse and a clinician, with patient satisfaction evaluated at a minimum of six months following surgery. Data was collected through retrospective review of electronic patient records. Results Among 150 patients (178 procedures), indications for penile prosthesis (PP) implantation included priapism n=39 (26%), phalloplasty n=36 (24%), neurogenic causes n=33 (22%), other n=26 (17%), and psychogenic erectile dysfunction n=16 (11%). Sixteen men with psychogenic erectile dysfunction underwent PP surgery; 14 were primary insertions and 2 revisions (excluded from analysis). The mean age was 33 years (range 28–39) with a mean follow-up of 42 months. All received three-piece inflatable devices. Ten patients (71%) had undergone both medical and psychosexual therapy, while 4 declined psychological input. Median hospital stay was one night. No 90-day readmissions or revision procedures occurred. One Clavien–Dindo grade II complication was recorded. Overall satisfaction was 93%, with one patient dissatisfied due to reduced glans sensation and tumescence Conclusions This contemporary UK series demonstrates that penile prosthesis implantation in men aged ≤40 years with psychogenic erectile dysfunction is associated with high satisfaction, short postoperative hospital stay and low complication rates. Penile prosthesis insertion is a safe and effective treatment option for younger patients with erectile dysfunction refractory to medical and psychological therapies. Disclosure No
Lindsay et al. (Mon,) studied this question.