title: A case of mechanical failure with proximal perforation at the time of revision surgery.
abstract: BACKGROUND
  Implantation of inflatable penile prosthesis (IPP) is a well-established treatment for medically refractory erectile dysfunction with proven long-term reliability. However, if an IPP fails, the subsequent surgery to fix the IPP can be more difficult with higher risks of complications than the primary implantation. Aims. To review and evaluate a case of a difficult IPP replacement surgery for ways to improve surgical techniques and outcomes.
  
  
  METHODS
  Perform a case report of a difficult IPP replacement surgery in which the patient had proximal perforation of the tunica albuginea with a review of the pertinent literature. Results. The rear tip sling is a successful way to repair proximal perforation of the tunica albuginea. Recent publications show new surgical techniques to lower infection rates in IPP revision surgery.
  
  
  CONCLUSIONS
  The rear tip sling appears to have better outcomes than a synthetic windsock for repairs of proximal perforation of the tunica albuginea. Recent publications have shown that the revision washout decreases penile prosthesis infection rates in revision surgeries.
  
  
  CONCLUSIONS
  While revision surgery for IPPs have higher risks than primary implantation, newer surgical techniques are helping to reduce these risks.
authors.affiliation: Department of Urology, Vita-Salute University, Milan, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Zanoni
authors.forename: Gerard D
authors.initials: GD
authors.lastname: Henry
mesh_terms: D000368:Aged; D006801:Humans; D018783:Impotence, Vasculogenic / Q000601:surgery*; D008297:Male; D019935:Penile Implantation / Q000009:adverse effects* / Q000295:instrumentation; D010413:Penis / Q000293:injuries* / Q000601:surgery; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation; D013997:Time Factors; D017211:Treatment Failure