Mitomycin c can minimize corporal scarring following explantation of an infected penile implant

Abstract

Delayed replantation following extrusion of an infected penile implant is hindered by the corporal scarring that issues. This renders the procedure difficult and with a higher rate of complications. In addition to the anti-tumour anti-biotic properties of Mitomycin C, it is known to be a potent anti-fibrotic agent with multiple applications in surgery such as esophageal atresia and bladder neck strictures. This work aims to evaluate the efficacy and safety of Mitomycin instillation upon removal of infected implants in preventing or minimizing corporal scarring Twelve patients with infected penile implants were included in the study. Upon extraction of the infected implant, corporal bodies were irrigated with antibiotics and antiseptics. This was followed by instillation of Mitomycin C, 10 mg in 250 cc saline, 125 cc into each cavernous space. Caution was observed to prevent contact with corporotomy and skin edges. The latter were freshened and closed. Re-implantation was performed 10-12 weeks subsequently. Four patients received an inflatable 3-piece implant and eight received a malleable. The cavernous cavity was found preserved, though tunica albuginea was thickened in all cases. Corporal dilatation was without resistance, using blunt Hegars. Ten patients received the same size of implant in length and girth. Two cases received a shorter implant (1 cm in one patient and 1.5 in the other). No re-infection, extrusion or urethral injuries were encountered. Two patients exhibited superficial skin ulcerations that resolved with topical care over 6-8 months. Mitomycin C instillation upon explantation of an infected penile prosthesis minimizes corporal scarring. Patients should be warned as to the possibility of postoperative skin ulceration. We believe this can be prevented by implantation of a narrower girth if the tunica albuginea is evidently thickened. None