Modified Double Distal Corporal Anchoring Stitch for Lateral Penile Prosthesis Cylinder Extrusion: A Glans-Sparing Approach

Mahdi, M, Khalafalla, K, Gamal, A, Pereira, T, Wang, R

Penile prosthesis erosion, impending cylinder erosion, distal anchoring stitch

This video demonstrates a modified double distal corporal anchoring stitch technique for managing lateral penile prosthesis cylinder impending erosion; this modification specifically avoids a glans incision. We present the case of a 66-year-old male who developed a new penile curvature and bilateral distal lateral cylinder extrusion six weeks after IPP surgery.

The video illustrates a surgical repair that combined a plaque incision and grafting (using a slicing technique to correct the curvature) with distal extracapsular tunneling (Mulcahy distal corporoplasty) and the novel modified distal corporal anchoring stitch technique to address the cylinder extrusion. This innovative approach involves tunneling the cylinder threads under the glans skin, thereby avoiding the need for a glans incision. The patient experienced a smooth postoperative recovery, reporting no issues at five-month follow-up and demonstrating proper cylinder positioning.

This modified technique offers a less invasive, faster, and potentially less painful option for managing distal lateral cylinder extrusion, leading to improved cosmetic outcomes compared to standard approaches requiring a glans incision.

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