Management of proximal penile prosthetic cylindrical complications: a novel direct crural approach

Basic and Clinical Andrology

Johnny Boustany¹  Abdalla Alhammadi²  Sébastien Beley²  Abdulmajeed Althobity²  Ahmed S. Zugail³  Maher Abdessater⁴  Mabel Nuernberg⁵ 

[1] Department of Urology, Henri Mondor University Hospital, Créteil, France;Department of Urology, La Croix Saint Simon Hospital, Paris, France;Department of Urology, La Croix Saint Simon Hospital, Paris, France;Department of Urology, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia;Department of Urology, Sorbonne Université, APHP, Pitié Salpêtrière, 83 bvd Hopital, 75013, Paris, France;Faculty of Medicine, Sorbonne University, Paris, France;Department of Urology, La Pitié Salpêtrière University Hospital, Paris, France;Faculty of Medicine, Sorbonne University, Paris, France;

关键词: Crural approach;    Erectile dysfunction;    Penile implantation;    Penile prosthesis;    Prosthesis failure;    Voie d’abord crurale;    Dysfonction érectile;    Implant pénien;    Prothèse pénienne;    Complications prothétiques;   

DOI  :  10.1186/s12610-020-00115-3

来源: Springer

【 摘 要 】

IntroductionPatients with proximal penile prosthetic cylindrical complications (PPPCC) can be treated with a direct crural technique without using the original traditional approach. In this article we present our novel direct crural approach for management of patients with PPPCC.Materials and methodsBetween 2014 and 2019, data were retrospectively collected from 13 patients who underwent surgical revision using our novel direct crural approach for PPPCC. The procedure commences with identification of the affected zone. The patient is in a low lithotomy position. A 2-centimeter longitudinal incision is made directly over the affected site. Dissection is carried down through Colles’ fascia, followed by a longitudinal incision through the tunica albuginea at the proximal part of the affected cylinder. Via the incision we can deliver out the cylinder and manage its problem.ResultsMean operative time was 40 min. No intra or post-operative complications were reported. All patients (Mean age = 57) were discharged on the same day. Postoperative follow-up found correction of all existing deformities at month 1, 3 and 6. All patients were satisfied and reported less pain and faster recovery than the first procedure.ConclusionOur technique, which can be used for all types of penile prosthesis, is both feasible and safe. It may simplify PPPCC revision by avoiding adhesions below the original incision, without jeopardizing the already implanted materials or the urethra. It may also improve patients’ safety and satisfaction, by reducing iatrogenic injury and post-operative recovery time.

【 授权许可】

CC BY