We appreciate the thoughtful and constructive commentary by Frazier et al. on our recently published prospective study evaluating a “zero infection protocol” in inflatable penile prosthesis (IPP) surgery [1]. In their comment, they appropriately contextualize our findings within the contemporary prosthetic infection literature, emphasizing that despite advances in skin antisepsis, antibiotic prophylaxis, surgical technique, and surgeon experience, postoperative infection following IPP placement has not been completely eliminated and remains approximately 1–2% in modern series. They further underscore the multifactorial nature of prosthetic infections, including the influence of patient comorbidities, operative time, antimicrobial strategies, and institutional experience, and they caution against interpreting results from single-center, small prospective cohorts as definitive evidence of universal infection eradication [2].

First, we fully acknowledge that no surgical approach can eliminate the risk of infection in inflatable penile prosthesis (IPP) surgery. The term “zero infection protocol” was used descriptively to reflect the outcomes observed in our prospective cohort of 103 consecutive patients with zero postoperative infections. It was not intended to imply that infection risk can be universally eradicated. As Frazier et al. note, modern multicenter studies report infection rates of approximately 1–2% even under optimized conditions [3].