Penile size prediction post-prosthesis implantation via intraoperative intracorporeal injection; a novel tool
Zaazaa, AA1; Ragheb, AM2
1: Cairo University, Egypt; 2: Beni-Suef University, Egypt
Objectives: Introducing a tool to predict post-implant penile size by preservation of stretched penile length while maximizing girth during penile prosthesis implantation (PPI).
Material and Methods: Thirty-two patients undergoing PPI were injected intraoperatively with 40µ alprostadil intracorporeal injection (ICI). PPI began as soon as maximal tumescence was noted. Both relaxed and maximally stretched penile dimensions (length and girth) were recorded before and after ICI. Penile length was measured from symphysis pubis to tip of the glans while girth was measured midshaft. In all cases, prostheses were implanted to extend no farther than the proximal third of the glans. Final measurements of utilized implant and penile size were noted immediately upon wound closure.
Results: The mean preoperative stretched penile length was significantly longer (15.4 ±1.7 cm) compared to the preoperative pharmacologically induced erect penile length (12.8 ±1.5 cm) [P<0.0001]. However, it corresponded to the mean postoperative penile length (15.2 ± 1.5 cm) [P=0.1] which also was significantly larger than preoperative pharmacologically induced length. [P<0.0001]
The mean stretched penile girth (9.1 ±1.4 cm) was significantly smaller than both the preoperative pharmacologically induced erect penile girth (11.5 ±1.4 cm) [P<0.0001] and the mean postoperative penile girth (11.2 ±1.7 cm) [P<0.0001] with the latter two being almost equal.
Conclusion: Post-ICI PPI combines the advantage of preserving preoperative stretched penile length while significantly maximizing girth. Pharmacological corporeal dilation, compared to conventional, may introduce a novel predictor of post implant penile size which will allow practical setting of patient expectations preoperatively, guide the choice of implant size intraoperatively and maximize penile size postoperatively.
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