401 Penile Prosthesis Placement in Patients with Corporal Fibrosis Secondary to Infection or Priapism: Outcomes and Complications

Abstract

Corporal fibrosis can make the insertion of a penile prosthesis very challenging and is associated with high complication rates. Common causes of this pathology include prior infection, history of priapism, radiation therapy, poorly controlled diabetes, Peyronie’s disease, etc. Dilation of the corpora both distally and proximally often require the use of cavernotomes, Rarely, sharp corporal excision may be necessary if the corporal fibrosis is severe. The aim of this study was to investigate the outcomes and complications of penile prosthesis placement in patients with corporal fibrosis. This is a single institution retrospective IRB approved study of 31 patients (mean age 52 years, range 31-74 years), with corporal fibrosis who underwent placement of penile prosthesis during a 16-year period. Etiologies of fibrosis included history of penile prosthesis infection (45.2%, 14/31), priapism (35.4%, 11/31), removal of penile prosthesis due to erosion of prosthesis (6.5%, 2/31), aborted IPP surgery in the setting of urethral injury (3.2%, 1/31), and idiopathic cause (6.5%, 2/31). With regards to surgical techniques, sharp corporal excision was utilized in 5 patients (16.1%), cavernotomes in 9 patients (29.0%), and a combination of both sharp excision and cavernotomes in 11 patients (35.5%). In 6 patients (19.4%) where fibrosis was notable, the surgeons were able to dilate the corpora without the aforementioned specialized techniques, although more difficult. Complications included malpositioned prosthesis (9.7%, 3/31), distal erosion (3.2%, 1/31) and infection (3.2%, 1/31).