Successful complex penile prosthesis implant in patients with high risk of fecal contamination: a two case report.

BACKGROUND: Penile prosthesis implantation in patients at risk of fecal contamination presents a significant infection risk and is rarely reported. CASE PRESENTATION: We report two male patients (aged 26 and 42 years) with refractory erectile dysfunction following multimodal treatment for carcinoma anorectum. One patient had a permanent colostomy after abdominoperineal resection, while the other developed persistent fecal incontinence following low anterior resection. Both failed conservative therapies and underwent malleable penile prosthesis implantation under strict aseptic precautions, including extended skin preparation, isolation of contaminated sites, double draping, and intraoperative antibiotic irrigation. Postoperative recovery was uneventful, with no evidence of infection at 3-month follow-up. CONCLUSION: Penile prosthesis implantation can be safely performed in selected high-risk patients with fecal contamination risk when meticulous perioperative infection control strategies are implemented.