Daniar Osmonov
This video was filmed in the Department of Urology and Pediatric Urology University Hospital Schleswig Holstein in Kiel, Germany.
The case: A 54 year-old patient presented with organic erectile dysfunction due to Peyronie’s disease and underwent surgery.The IIEF-5 score was 9, the EHS Score was 0. The patient was a non-responder to PDE-5 inhibitors and to Alprostadil and had been suffering from a stable Peyronie’s disease for over one year.
A transurethral catheter is placed prior to surgery. An artificial erection is initiated by infusion of saline via a 21 G needle into the CC, after placing a tourniquet around the proximal shaft. A 60 degree penile deviation is created as shown on the video. The tourniquet is released and the butterfly needle is removed.
A penoscrotal implantation of penile prosthesis with classic reservoir placement is performed. Our video describes all steps of the surgery. We use a 20 cm long Coloplast Titan Touch prosthesis and a 3 cm RTE on both sides.
The modeling Wilson´s procedure was performed after implant was placed: rubber-shod clamps placed on the cylinder tubing help to protect the pump. Two fingers are placed on one corporotomy, and the thumb is placed on the other corporotomy. The penis is then bent hard in the direction opposite to the curvature for ca. 90 seconds.
After 90 seconds, the clamps are removed In our case, the 60 curvature was reduced to a 30 curvature in a single modeling maneuver.
After modeling session, the prosthesis is deflated completely and then re-inflated while pulling on the guide sutures of the cylinders. It is only inflated up to 75% when judging the result. In our case, the postoperative results after 12 weeks were satisfying.