V07-12 Development of a High Fidelity 3-piece Inflatable Penile Prosthetic (ipp) Model Using 3d-printing and Hydrogel Molding
Year: 2020
Type: article
Abstract: INTRODUCTION AND OBJECTIVE: In patients with virgin tissue planes and normal anatomy, penile prosthesis placement can be technically straight forward and associated with minimal morbidity.However, prosthesis implantation in patients with corporal fibrosis is associated with a higher risk of implant failure and infection.The most technically challenging component of this procedure is creating space within the corpora to allow appropriate accommodation and expansion of the implant cylinder.There is no standardized approach to prosthesis implantation in these patients and surgical technique selection can vary depending on the extent of corporal fibrosis and surgeon experience.Thus, with this video, we seek to show a novel technique for prosthesis placement in a patient with severe corporal fibrosis, using penile invagination with complete corporotomies and corporal excavation.METHODS: The procedure begins by inducing an artificial erection with a mixture of sterile saline and 2% lidocaine as it both helps dilate the corpora and provides excellent local anesthesia.A midline perineal incision is made and the dissection of the corpora and urethra is carried out en bloc.The penis is then invaginated into the perineal wound and placed on traction with a Penrose drain, exposing both corpora along their entire length 3-0 silk sutures are used to mark the medial and lateral edges of the left corporal body.Bovie cautery is used to make a vertical corporotomy along the full length of the corpora.The fibrotic tissue rarely bleeds.Extensive corporal excavation with corporal scar removal from the tunica albuginea is then performed to create enough space to allow for a prosthesis to be placed.After removal of diseased and fibrotic tissue, the implant is placed.A Furlow device is used to measure corporal length.A Genesis malleable prosthesis can be used as it may be cut to length.The corporotomies are closed with 2-0 PDS suture in a running fashion.For reinforcement of the closure, overlay Tachosil, a self-adhesive collagen fleece.Following completion of the other side, the penis is reduced to its anatomic position.Both implant tips should be symmetric and palpable in the mid glans.The incision is then closed in the standard fashion RESULTS: The patient tolerated the procedure well.He had an excellent post operative outcome and was pleased with the results at his follow up appointment CONCLUSIONS: Penile invagination with full length corporotomies and corporal excavation with penile prosthesis placement represents a good option for prosthesis placement in patients with severe corporal fibrosis.
Source: The Journal of Urology
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W3022385183