OBJECTIVE To assess the factors associated with loss of implant following penile prosthetic surgery and to make alterations in the management of patients to prevent this from occurring. PATIENTS AND METHODS A retrospective analysis was carried out of the factors associated with post-operative infection and erosion in 188 patients who underwent implantation of penile prostheses. A prospective study was then established in which 62 patients were managed by a set protocol designed to counteract the factors identified as being contributory to loss of implants in the retrospective review. RESULTS In the retrospective study nine (4.8%) patients lost a prosthesis due to erosion. Erosion was noted to be more common with one type of implant which has since been modified. Infection was the cause of prosthesis loss in 12.2% of patients in the retrospective review. The new protocol resulted in a significantly reduced infection rate in penile prostheses to 1.6% (P < 0.05). CONCLUSION With attention to simple antiseptic prophylaxis, antibiotic penetration and continuing audit, a significant improvement in the loss of penile prostheses can be achieved along with a reduction in the amount of antibiotics prescribed.