HP-6-2 Minimizing Corporal Scarring after Penile Prosthesis Removal: A Case Series

Introduction: We present a case report on six patients who underwent a combined approach to improve the cosmetic appearance and functional performance of their buried penis. Aim: To report our combined approach to improve both buried penis and erectile dysfunction. Methods: In one surgery, we performed: a malleable penile prosthesis, ventral phalloplasty, and penile suspensory ligament release followed by a suprapubic lipectomy. Results: Postoperatively, all patients had an increase in penile length and were able to achieve successful penetrative intercourse. The average difference between the pre-operational and post-operational flaccid length of our six patients was 3.5 cm ± 1.38 (range, 1.9 to 5.08 cm). Conclusion: This case series serves as successful examples of using a combined approach in one stage to not only improve the cosmetic appearance of a buried penis but also address erectile dysfunction.

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P154 DOES A PENO-SCROTAL APPROACH FOR PENILE PROSTHESIS IMPLANTATION INCREASE THE INCIDENCE OF INGUINAL HERNIAS POSTOPERATIVELY?

British Journal of Surgery ◽

10.1093/bjs/znab395.144 ◽

2021 ◽

Vol 108 (Supplement_8) ◽

Author(s):

Shadi Al-Bahri ◽

Hazem Taifour

Keyword(s):

Risk Factors ◽

Inguinal Hernia ◽

Case Series ◽

Penile Prosthesis ◽

Signs And Symptoms ◽

General Surgeon ◽

Direct Inguinal Hernia ◽

Prosthesis Implantation ◽

Radiologic Imaging ◽

History Of

Abstract Aim The incidence of direct inguinal hernia and reservoir migration post-penile prosthesis implantation is extremely rare. We present a case series of patients presenting with direct inguinal hernia following three-piece penile prosthesis implantation. Material and Methods Three patients presented with direct inguinal hernia shortly following penile prosthesis implantation for treatment of refractory erectile dysfunction due to venous leak that was confirmed on ultrasound imaging. All patients underwent standard open Lichtenstein tension free repair. Results All patients underwent penile prosthesis Implantation through a peno-scrotal approach in which the reservoir was placed in the space of Retzius. The first patient had reservoir displacement one day post-operatively presenting as an inguinal bulge and discomfort, and repaired the same day. The other two patients presented with symptoms of inguinal swelling and pain at 40 days and 8 months respectively. None of our patients had signs and symptoms of intestinal obstruction. Identifiable risk factors included high BMI and a history of smoking, however dissection and placement of the reservoir may play a role in weakening the floor of the inguinal canal. Conclusions Despite the rare incidence of inguinal hernia post-penile prosthesis implantation, identification of patients with risk factors for inguinal hernia development should be done preoperatively. This may be evaluated through preoperative radiologic imaging with an abdominal wall ultrasound or clinical examination by a general surgeon.

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