(413) Obturator Fenestration Technique for the Woody Indurated Penis

Abstract

Abstract Introduction Performing penile implant surgery can be challenging especially in the presence of a woody indurated penis (e.g. post priapism, post infection, prolonged h/o ICI, etc.) The loss of corporal smooth muscle cells and excess of collagen deposition caused by corporal fibrosis can create challenges and increase risk of perforation, crossover and certainly infection. Clinically, these fibrotic corpora make placement of a penile prosthesis a difficult surgical procedure. Objective We demonstrate how the Obturator Fenestration Technique facilitates placement of a penile implant in the woody indurated penis. Methods 48 y/o male w/ Hx of a 3-day Priapism treated with a shunt at the time. Patient was not offered a penile implant until 8 months following event. At the time of penile implant surgery the urologist placed a malleable halfway up on the right corpora and did not attempt the other side and case was aborted. Physical examination revealed diffusely woody indurated corporeal tissue throughout the left corpora and distally on the right corpora Results Penile implant was successfully implanted using the obturator fenestration technique in the woody indurated penis in the patient with a previously failed attempt at implantation. Conclusions The use of the Obturator Fenestration Technique can help facilitate increasingly complex cases This can help reduce unnecessary complications and repeat revision surgery. However, there is a learning curve while using the Obturator Fenestration Technique and should not be performed by a novice surgeon We hope to improve our techniques and surgical approaches to improve surgical times and post-operative outcomes for the woody indurated penis Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Coloplast, Boston Scientific