Reduction corporoplasty after inflatable penile prosthesis revision failure
Rajih, E1; Burnett, AL2
1: Taibah University, Saudi Arabia; 2: Johns Hopkins Hospital, United States
Objective: Despite the role of inflatable penile prosthesis (IPP) revision surgeries, failed IPP revisions may be encountered secondary to unrecognized proximal corporal abnormalities. We present the management and outcomes of a series of failed IPP revision surgeries in the context of isolated proximal corporal deformities including a new observation of clinically assessed IPP instability (Wobbly Penis).
Material and Method: A retrospective analysis of the Johns Hopkins Hospital institutional database of IPP surgery from May 2006 to March 2017 consisted of 198 patients who had IPP revision surgeries. All cases requiring surgical revisions secondary to isolated proximal corporal deformities were identified. Data retrieved included clinical characteristics, operative findings, and surgical outcomes.
RESULTS: 15 patients with proximal corporal deformities (proximally from the penoscrotal junction) were identified (Table 1). Twelve patients reported intact cycling but unstable and not usable devices. The mean prior IPP surgeries were 4.2 times and the mean IPP treatment duration was 13.8 years. Corporal rupture was identified in 7 patients (46.7%) and device breakage was found in 4 patients (26.7%). All underwent reduction corporoplasty with controlled expansion IPP replacement. At 6.5 months median follow-up time, all IPPs were intact and functional. All patients reported successful vaginal intercourse.
CONCLUSIONS: Proximal corporal dilatation is a penile structural deformity that may account for IPP failure. Delayed surgical intervention and incorrect revision may predispose to device instability, prosthesis cylinder aneurysmal dilatation, prosthesis cylinder breakage, and corporal body/tunical rupture. Proper recognition of this problem allows the opportunity for surgical correction with reduction corporoplasty.
Work supported by industry: no. The presenter or any of the authors act as a consultant, employee (part time or full time) or shareholder of an industry.Go Back