(05) Cylinder Crossover and Perforation

VJPU 2014; 1: 033

Steven K Wilson

Key Words: Crossover, Cylinder Perforation, Penile Implant

This video covers the postoperative complications of cylinder crossover which causes penile deformity and proximal perforation which results cylinders that appear too short with lack of support for the glans penis. Crossover is the result of fenestrations in the septum of the penis and the crossover is usually the result of an over and back passage of the Furlow insertion Tool rather than firing the Furlow through the contralateral glans. Crossover can occur in the distal or proximal portion of the penis. The complication is difficult to diagnose at the time of surgery but is very evident after multiple inflations by the patient over time. The simple repair of the problem is illustrated.

The second part of the video covers proximal corporal perforation. The authors suggest the problem is very common during difficult insertions of penile implant into scarred corporal bodies and believe it occurs as often as 50% of the time. There are many suggested repairs using synthetic material but the authors believe using a rear tip extender sling of non- absorbable suture is quite effective. How to construct the sling is illustrated by medical illustration and live surgery.

Acknowledgements: Educational grant from Coloplast

Disclosures: Consultant Abeon, AMS, Coloplast, NeoTract

References:

  1. Wilson SK. Pearls Perils and Pitfalls of Penile Prosthesis. 2008 Calvert McBride, Fort Smith AR
  2. Wilson SK, Delk JR: A New Technique to Repair Proximal Corporal Perforation During Prosthesis Implantation: Rear Tip Extender Suture Sling. J Urol 173 (4): 342, 2005.
  3. Wilson SK. Surgical Techniques. Rear Tip Extender Sling: A Quick and Easy Repair for Crural Perforation. J Sex Med 2010; 7:1052-55