Management of Distal Extrusion of Penile Prosthesis: Partial Disassembly and Tip Reinforcement by Double Breasting or Grafting

Authors


Osama Shaeer, MD, Andrology, Faculty of Medicine, Cairo University, 21 Gaber Ibn Hayan Street-Dokki, Cairo, Egypt, 12311 ARE. Tel: 0020106600606; Fax: 0020227605181; E-mail: dr-osama@link.net; Web: http://www.maleGENITALsurgery.com

ABSTRACT

Introduction.  Distal erosion and perforation of penile prosthesis have been reported in association with neurologic impairment, diabetes mellitus, and following irradiation for prostatic cancer. Once perforation occurs, reimplantation carries a higher risk of reperforation unless adequate preventive measures are taken.

Aim.  This is a description of a procedure whereby the point of perforation was exposed and repaired to restore distal support.

Methods.  In three patients with distal extrusion of penile prosthesis through the urethra, the glans was mobilized off the tip of the corpus cavernosum and the caverno–urethral fistula was disconnected from the corpus cavernosum. The fistula was sealed by primary sutures. The perforation on the corpus cavernosum side was sealed by double breasting in two cases and by grafting in one case. Prosthesis was reimplanted.

Main Outcome Measures.  Complications, recurrence of erosion, and postoperative coital pain.

Results.  No complications, recurrence, or persistent pain occurred in any of the three cases.

Conclusion.  The management of the distal extrusion of penile prosthesis by partial disassembly, double breasting, or grafting may provide reliable distal support and thereby avoid reperforation and repeated extrusion. Shaeer O. Management of distal extrusion of penile prosthesis: Partial disassembly and tip reinforcement by double breasting or grafting. J Sex Med 2008;5:1257–1262.

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