Shaeer's Cavernotome for Penile Prosthesis Implantation in Scarred Corpora Cavernosa.

Abstract

Penile prosthesis implantation in scarred corporal bodies is one of the most challenging urologic procedures, with high risks of perforation and/or failure. We present Shaeer's Cavernotome (patent application number PCT/EG2021/050003). This is the forward-cutting cavernotome that relies on the principle of controlled coring and grinding rather than forward stabbing, with fibrous tissue accommodated into the hollow core, thereby ensuring high efficacy and low risk of perforation. This is a prospective study involving 18 patients with severe corporal scarring. Surgery is performed through a peno-scrotal incision with an indwelling urethral catheter. Corporotomies are incised and a 2-cm-long core of fibrous tissue is excised with a scalpel. Shaeer's Cavernotome is introduced and lodged against the fibrous tissue. Coring proceeds with the stretched corpus or crus held between the thumb and index fingers of the non-dominant hand as a guide, ahead of the tip. Shaeer's cavernotome doubles as a sizer. Following coring, penile prosthesis implantation proceeds. Dilation of the corpora cavernosa was successful in 17 out of 18 patients. Average coring time was 8 ± 3.2 minutes. Dilation was up to girth 13 Hegar in 12 patients, and 11 in 5. No perforations or infections were encountered. Shaeer's cavernotome facilitates penile prosthesis implantation in scarred corporal bodies. Full excavation of both corpora cavernosa is achievable in less than 10 minutes, with a low risk for perforation.