Corporeal excavation: new technique for penile prosthesis implantation in men with severe corporeal fibrosis.
BACKGROUND
Penile prosthesis implantation in men who have fibrotic corpora as the result of ischemic priapism or previous removal of an infected penile prosthesis poses a significant challenge to the implanting surgeon. We describe a new technique, corporeal excavation, to meet this challenge.


METHODS
The operative approach is through an inverted T penoscrotal incision that affords exposure of nearly the entire corpus cavernosum on each side. Extended corporotomies are made on the ventral aspect of each corpus cavernosum, and a plane of dissection between the fibrotic corporeal tissue and the inner surface of the tunica albuginea is established, resulting in core removal of nearly all fibrotic intracorporeal tissue. Cylinders are laid into the empty corporeal bed, and the tunica albuginea is closed primarily. Nine patients were identified who had undergone this procedure. The operative notes and medical records were reviewed, and telephone interviews were done for follow-up when patients had not been recently seen in the clinic.


CONCLUSIONS
Successful outcomes were achieved in all 9 patients. Corporeal excavation permits penile prosthesis implantation in men with severe intracorporeal fibrosis usually resulting from priapism or previous removal of infected penile prostheses.
Montague
Drogo K
DK
Section of Prosthetic Surgery and Genitourethral Reconstruction, Glickman Urological Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA. montagd@ccf.org
Angermeier
Kenneth W
KW
D020878:Device Removal / Q000009:adverse effects; D048909:Diabetes Complications; D007172:Erectile Dysfunction / Q000209:etiology / Q000601:surgery*; D005355:Fibrosis; D006801:Humans; D008297:Male; D019935:Penile Implantation / Q000379:methods*; D010413:Penis / Q000473:pathology* / Q000601:surgery*; D011317:Priapism / Q000150:complications; D016459:Prosthesis-Related Infections / Q000150:complications