(061) CASE SERIES: PERSISTENCE OF FUNCTIONAL PENILE CAVERNOSAL TISSUE FOLLOWING EXPLANT OF PENILE PROSTHESIS

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Abstract Introduction Placement of a penile prosthesis is a safe, reliable treatment for erectile dysfunction. Unfortunately, regardless of patient satisfaction, some prostheses must be removed for select indications. It is widely believed that after explant of a penile prosthesis, patients will have no chance of penetrative intercourse without another penile prosthesis. Implantation of a penile prosthesis disrupts the inner corporal cavernosal sinusoidal tissue, and it is believed that remaining tissue cannot attain meaningful erections. However, we have observed several patients with varying degrees of persistent erectile function following explant, challenging this dogma. Objective We present a series of patients who pursued medical management of erectile dysfunction following penile prosthesis explant. Methods We identified all patients at our practice that underwent explant of penile prosthesis and wished for salvage of erectile function from June 2023 to December 2023. Chart review was performed to abstract demographic and clinical data. Descriptive statistics were not applicable. Results Following explant of penile prosthesis, 4 patients were motivated to continue management of erectile dysfunction. Three of these patients underwent penile duplex ultrasonography, results in Table 1. Arterial sufficiency is demonstrated in each ultrasound. One patient progressed to salvage medical management with intracavernosal injections and attained functional erections. Conclusions The patients identified demonstrate evidence of functional, viable corporal cavernosal tissue several years following penile prosthesis placement. Our data presents both objective and subjective evidence of successful erectile potential. This is a small case series with short-term follow up, but these results directly counter the current paradigm-some patients can experience efficacious medical management of erectile dysfunction following explant of penile prosthesis. Further investigation with larger patient cohorts is warranted to better define treatment options for patients’ sexual health following prosthesis explantation. Disclosure No.