Corporoscopic excavation of the fibrosed corpora cavernosa for penile prosethesis implantation: optical corporotomy and trans-corporeal resection, Shaeer's technique.
BACKGROUND
Implantation of a penile prosthesis in cases of neglected or resistant ischemic priapism, or delayed re-implantation following prosthesis infection and extraction, is usually a difficult and risky procedure due to fibrosis of the corpora cavernosa. Among the common complications are perforation of the urethra, tunica albuginea, and infection. The complications are usually due to the use of blind force against resistance.


OBJECTIVE
We propose the techniques of Trans-Corporeal Resection and Optical Corporotomy as adjuvant measures for excavating the fibrosed corpora cavernosa under vision, without the use of force against resistance.


METHODS
Six patients with diffuse fibrosis of the corpora cavernosa were operated on. The instruments and technique are the same as for optical urethrotomy and transurethral resection. Optical Corporotomy was started with, where the corpora are incised from within. After establishment of a satisfactory passage, Trans-Corporeal Resection followed to scrape the fibrous tissue. Implantation of penile prosthesis was completed as usual. The procedure was performed through 1.5 cm incision in the tunica albuginea.


METHODS
Length, girth, and straightness in the erect position, as well as the incidence of complications.


RESULTS
Operative time was an average of 90 minutes. No difficulty was encountered during the procedure. No complications were noted through 1 year of follow-up.


CONCLUSIONS
Optical Corporotomy and Trans-Corporeal Resection allow for force-free, visually monitored excavation of the fibrosed corpora cavernosa, aiming at safer penile prosthesis implantation.
Shaeer
Osama
O
Faculty of Medicine, Cairo University, Cairo, Egypt;. Electronic address: dr-osama@link.net.
Shaeer
Ahmed
A
Kamal Shaeer Hospital, Cairo, Egypt.
D007172:Erectile Dysfunction / Q000209:etiology / Q000601:surgery*; D005355:Fibrosis; D006801:Humans; D008297:Male; D019935:Penile Implantation / Q000379:methods*; D010411:Penile Induration / Q000601:surgery*; D015917:Penile Prosthesis; D010413:Penis / Q000473:pathology / Q000601:surgery*; D011317:Priapism / Q000150:complications; D016459:Prosthesis-Related Infections / Q000150:complications; D016896:Treatment Outcome; D013521:Urologic Surgical Procedures, Male / Q000379:methods