We initiated a prospective study of penile prosthesis implant surgery toevaluate risk factors for infection and other complications. Twenty-onepatients admitted for surgery or related complications were evaluated over aseven-month period. The two types of penile prostheses implanted were (1)inflatable and (2) semirigid. Nine of 21 patients (43%) developedpostoperative complications. Although cephapirin and gentamicin were givenprophylactically, four of nine patients had four wound infections and onecase of pneumonia. One case of Bacteroides fragilisbacteremia was due to stool incontinency during surgery. In two of the woundinfections, removal and reinsertion of the prosthesis was necessary. Othercomplications included hypotension during surgery, prosthesis malfunctionand malposition, and urethral tears. There were no significant associationsbetween infection and age, length of surgery, or type of prosthesis used.These complications contributed to prolonged hospital stay and readmission(87 extra days for the infected patients at a cost of $44,000). Antibioticcosts to treat the infections totaled $1,900. Prospective evaluation byinfection control practitioners of various elective surgeries can be usefulin quantitating the complication rate and targeting patients at risk, withthe goal of minimizing hospital costs.