Penile Flexiflate® Surgitek Prosthesis Explant and Simultaneous Three-Component Hydraulic Titan® Alpha 1 Prosthesis Implantation, with Double Incision Technique in a Patient with Kidney and Pancreas Transplant

Abstract

We treated a 45 years old patient, suffering from diabetes mellitus since childhood, with retinal, neurovascular and kidney complications. In 1988, for erectile dysfunction (ED) resistant to medical injective treatment, the patient underwent ligation of the dorsal vein of the penis without any result. In 1989 a Flexiflate® hydraulic prosthesis was implanted with resolution of ED. In 2005 the patient underwent simultaneous kidney and pancreas transplant with a trans-laparotomic approach for end stage renal disease and diabetes mellitus. In 2009, because of the Flexiflate® Surgitek malfunction, the patient underwent explantation of the Flexiflate® prosthesis and simultaneous implantation of a Titan® Alpha 1 prosthesis with a double surgical approach. After a peno-scrotal incision and the explant of the Flexiflate® Surgitek, a Titan® Alpha 1 prosthesis was implanted with a double incision technique. The placement of two inflatable cylinders and the pump was performed by peno-scrotal approach. Instead, the prosthesis' reservoir was placed with a separate infra-pubic incision to avoid possible injury from a single trans-inguinal approach, due to the previous laparotomy. After follow-up at 9 months and 1 year the prosthesis was working well and the patient satisfied. We couldn't find any related paper in the literature and as far as we know this is the only report on a simultaneous explant/implant of penile prosthesis with a double surgical approach in a patient with kidney and pancreas transplant.