Successful Complex Penile Prosthesis Implant in Patients with High Risk of Fecal Contamination: A Case Report

Background: Penile prosthesis implantation in patients at risk of fecal contamination poses significant surgical challenges due to the heightened possibility of postoperative infection. Case presentation: We report two cases of young male patients with refractory erectile dysfunction following multimodal treatment for carcinoma anorectum. The first patient had undergone abdominoperineal resection with colostomy in situ, while the second had a low anterior resection with subsequent reversal but developed persistent fecal incontinence. Both patients had normal hormonal profiles and had failed conservative management with oral and injectable agents. Malleable penile prosthesis implantation was performed under general anesthesia using rigorous aseptic protocols, including extended skin preparation, isolation of contaminated sites with specialized draping, and repeated intraoperative irrigation with broad-spectrum antibiotic solutions. Both procedures were uneventful, and postoperative follow-up demonstrated satisfactory healing and prosthesis function without infection. Conclusions: With meticulous preparation, field isolation, and surgical discipline, penile prosthesis implantation can be successfully achieved even in patients with a high risk of fecal contamination.