title: Management of Perforation Injuries During and Following Penile Prosthesis Surgery.
abstract: BACKGROUND
  Distal extrusion of penile prosthesis cylinders is a challenging problem that is associated with pain and imminent erosion through penile skin. Distal extrusion and other perforation injuries, including crural and urethral, are other manifestations of tunica albuginea injuries that result in poor clinical outcomes and patient satisfaction.
  
  
  OBJECTIVE
  A description of Dr. John Mulcahy's landmark article for management of lateral extrusion is presented along with discussion of techniques for managing other types of perforation injuries associated with penile implants.
  
  
  METHODS
  Dr. Mulcahy's original article is reviewed and critiqued. Surgical methods to manage perforation injuries are discussed.
  
  
  METHODS
  The main outcome measures used were the review of original article, subsequent articles, and commentary by Dr. Mulcahy.
  
  
  RESULTS
  Knowledge of techniques for management intraoperative and postoperative complications related to tunical perforation is necessary for implant surgeons.
  
  
  CONCLUSIONS
  Perforation injuries are challenging noninfectious complications of penile prosthesis surgery. Familiarity with techniques to manage these problems is essential for ensuring good outcomes and patient satisfaction.
authors.affiliation: Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Doron S
authors.initials: DS
authors.lastname: Stember
authors.affiliation: Urology, Southern Illinois University School of Medicine, Springfield, IL, USA.
authors.forename: Tobias S
authors.initials: TS
authors.lastname: Kohler
authors.affiliation: Urology, UT Southwestern Medical Center, Dallas, TX, USA.
authors.forename: Allen F
authors.initials: AF
authors.lastname: Morey
mesh_terms: D006801:Humans; D007431:Intraoperative Complications / Q000601:surgery*; D008297:Male; D017060:Patient Satisfaction; D019935:Penile Implantation / Q000009:adverse effects*; D015917:Penile Prosthesis / Q000009:adverse effects*; D010413:Penis / Q000293:injuries / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications / Q000601:surgery*; D017410:Practice Guidelines as Topic; D011475:Prosthesis Failure; D014521:Urethra / Q000293:injuries / Q000601:surgery*
keywords: Crural Perforation; Distal Extrusion; Erectile Dysfunction; Lateral Extrusion; Penile Prosthesis; Surgical Complication