Surgical management of complication of cylinder after grafting corporoplasty

Title: Surgical management of complication of cylinder after grafting corporoplasty

Author: Ahmad Shamsodini

Introduction: Penile prosthesis implantation and corporoplasty has a high patient and partner satisfaction in cases of Peyronie’s disease. Use of different types of graft for correction of bending and lengthening of corpora have gained great popularity.
We present a surgical management of complication of cylinder after 4 years of graft corporoplasty and penile prosthesis implantation.

Patient and Method: 55 years old gentleman who had graft corporoplasty and penile prosthesis implantation due to Peyronie’s disease 4 years prior to his presentation. He presented with prosthesis malfunction and migration of tip of left cylinder from below the glans and folding of the cylinder tip towards the opposite corpora. This was confirmed by MRI.The decision of implant replacement and corporoplasty was discussed with the patient and informed consent was obtained.

Surgical technique and result: Subcoronal, circumferential incision and degloving of the penile skin, left corpora (Previously Grafted) was exposed after elevation of Buck’s fascia.
Grafted area was found to be baggy and wide cavity that caused the cylinder to be migrated from its place and closer of distal corpora.
The corpora was dilated by brooks dilator up to below the glans and the corpora(Graft) was trimmed to reduce the corporal cavity to only accommodate the cylinder. Enforcement of the corpora by another graft and closure of the Bucks fascia over it.
The implant was replaced in classic fashion.

Post-operative and conclusion: The cylinders kept inflated for 3 weeks, the patient had smooth post-operative course. The patient was allowed to have an intercourse after 8 weeks of surgery and he gained his satisfaction. In conclusion, due to frequent use of graft in Peyronie’s disease and unavailability of standard graft we need to be ready to manage the complications of those procedures.