Distal corporotomy localisation is a risk factor for distal cylinder extrusion and rerouting surgery in penile prosthesis implantation

Abstract

<h3>Objectives</h3> The aim of this study was to identify risk factors for distal cylinder extrusion after primary prosthesis implantation. <h3>Methods</h3> A retrospective review was completed of all rerouting procedures in our centre from 2017-2020. All procedures were performed by the same surgeon. A total of 15 patients underwent rerouting surgery in this time interval. Characteristics of these patients were compared to the characteristiscs of a control group of 224 consecutive patients of the same surgeon penile prosthesis database. Following characteristics were taken into account: BMI, modeling (Wilson manoevre) during primary implant surgery, reintervention vs primary implant, Peyronie's disease, corporotomy ratio proximal/distal, total length of the implant and the length of the rear tip extenders (RTE). A generalized linear mixed model was applied to analyse the data. <h3>Results</h3> The only statistically significant risk factor we could withhold is the proximal to distal ratio of the corporotomy. Patients with a ratio of 1 have a probability of rerouting of 4.45% (95% CI: 2.68%-7.31%). The more distal the corporotomy, the higher the risk of cylinder dislocation. <h3>Conclusions</h3> The localisation of the corporotomy can be important in the prevention of distal cylinder dislocation; the more proximal the corporotomy, the lower the risk of dislocation and necessity of rerouting surgery. <h3>Conflicts of Interest</h3> none