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

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 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%, 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.