In this special Urology on the Beach edition of Pearls & Perspectives, host Amy Pearlman, MD, sits down with Gerard Henry, MD, to reflect on more than 2 decades of progress in penile prosthetics and how meticulous technique, data collection, and innovation—often driven from private practice—have reshaped infection prevention and device outcomes. Henry recounts his early work demonstrating that bacteria are commonly present even in clinically “uninfected” penile implant revisions and how revision washout protocols dramatically reduced infection rates, helping establish what is now standard of care. He shares longitudinal data showing a steady decline in culture-positive bacteria over the past 40 years and discusses emerging research comparing traditional cultures with DNA-based testing, which may reveal organisms missed by standard methods.The conversation explores evolving strategies that have further lowered infection risk, including no-touch principles, chlorhexidine skin preparation, antibiotic and customizable implant coatings, and growing interest in antiseptic-based solutions rather than antibiotics alone. Henry emphasizes that gram-negative organisms, particularly Pseudomonas, are more commonly implicated than historically taught, underscoring the need to rethink antimicrobial targeting.Beyond infection prevention, Henry highlights practical surgical innovations such as the “mummy wrap” and finger-sweep dissection, along with the importance of maintaining long-term clinical databases to generate meaningful real-world evidence. He advocates for innovation within private practice, encouraging clinicians to start with procedures they perform most often, systematically collect data, and consider intellectual property development through patents.The episode closes with a look toward future technologies, including Henry’s work on seal-based vasectomy using ligation energy technology, and a broader discussion of how cross-pollination from other specialties can inspire the next generation of urologic advances.

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