Prevention of urethral stricture in insertion of an inflatable penile prosthesis

An unexpected course after simultaneous urethral repair and reimplantation of penile prosthesis in a patient with a urethral stricture

We experienced the growth of urethral hair along the urethral stricture six years after simultaneous urethral repair and reimplantation of penile prosthesis (RPP) in a patient with a urethral stricture. We detected hair in the urethra with a stricture on the bulbous urethra. Further, we performed hair removal by using a pair of cystoscopic forceps and internal urethrotomy. Then, we performed RPP, and the patient voided well; the prosthesis worked very well and without any complications. One-stage urethroplasty with a pedicle island of the penile skin and RPP in a simultaneous stage may be an option for treating the long-segment urethral stricture in the penile prosthesis patient. However, we should pay attention to the urethral hair growth that can occur after urethral repair performed using a skin graft.

An unusual surgical success with a defective penile prosthesis

A defective penile prosthesis is disconcerting for the surgeon performing an implantation in a patient with erectile dysfunction. We became aware of the defective Titan penile prosthesis just after insertion of the left cylinder, which had an abnormal rotation (180 degrees) due to abnormal rotated tubing, which occurred at the manufacturing plant. We successfully performed the implantation by cutting and re-connecting the tubing between the cylinder and pump with a spare connector. When the surgeon encounters a defective penile prosthesis with abnormal rotation of the cylinder due to abnormal rotated tubing in the operative field, disconnection and re-connection of the tubing using an extra connector are alternative cost-effective maneuvers.

An unusual success with simultaneous urethral repair and reimplantation of penile prosthesis in a patient with urethral stricture induced by rotated tubing

INTRODUCTION

Simultaneous urethral repair and reimplantation of penile prosthesis in a patient with urethral stricture induced by rotated tubing of a three piece penile prosthesis has not been reported yet.

AIM

The aim of this study was to present our experience, which overcame severe urethral stricture induced by penile prosthesis implantation.

MAIN OUTCOME MEASURE

Uroflowmetry, voding cystourethrogram, function of prosthesis, and complications.

METHODS

We performed one-stage urethroplasty with pedicle island of penile skin and reimplantation of Titan penile prosthesis without abnormal rotation of the cylinder.

RESULTS

The patient voided very well, and the prosthesis worked very well without complications.

CONCLUSION

One-stage urethroplasty with pedicle island of penile skin and reimplantation of a three-piece penile prosthesis in simultaneous stage may be another choice to treat the long-segment urethral stricture occurred by three-piece penile prosthesis implantation.