Introduction. Implantation of penile prosthesis in case of corporeal fibrosis poses a greater risk of complications because of the blinded aggression involved. Penoscopic excavation and ultrasonography-guided excavation can decrease these complications but still have limitations.
Aim. This work described the combination of penoscopy-guided and ultrasound-guided excavation in a trial to eliminate the limitations inherent to both.
Methods. Twelve patients with penile fibrosis were operated upon. A guide wire was inserted under ultrasound monitoring, along which penoscopic corporotomy and resection was performed. Ultrasound was also used to monitor penoscopic excavation toward the tip of the corpus cavernosum and crus.
Main Outcome Measures. Ease of the procedure, safety, extent of dilatation, and girth of prosthesis implanted.
Results. The procedure was relatively easy. Ten cases were dilated up to size 13.5 Hegar, and two up to size 14. Size 13 prosthesis was implanted in all cases.
Conclusions. The relative safety of the procedure, the low incidence of complications, the possibility of restoring length and girth to an extent, and the resultant generous dilatation of the corpora for accommodating a sizable unhindered inflatable penile prosthesis all make ultrasound-guided penoscopic corporotomy and resection a valid option for prosthesis implantation in cases of penile fibrosis. Shaeer O. Implantation of penile prosthesis in cases of corporeal fibrosis: Modified Shaeer's excavation technique. J Sex Med 2008;5:2470–2476.