Systemic Perioperative Antimicrobial Prophylaxis for Penile Prosthesis Implantation: A Systematic Review

Background and Objectives: Penile prosthesis infection usually ends in device removal, whereas unnecessarily broad or prolonged prophylaxis causes toxicity and promotes resistance. We assessed whether the systemic perioperative antibacterial or antifungal strategy, dose or duration is associated with infection, infection-related explantation or reoperation or antimicrobial toxicity after primary or revision implantation. Materials and Methods: PubMed, Europe PMC, OpenAlex and ClinicalTrials.gov were searched from inception to 29 August 2026 using two complementary strategies that combined penile-prosthesis terms with antimicrobial-prophylaxis terms and, separately, with infection or explantation terms, without language or date limits, supplemented by related-article expansion and reference-list checking. Comparative primary studies were eligible. Risk of bias was appraised with RoB 2 and ROBINS-I, and random-effects models were fitted where independent cohorts reported compatible data.