IPP Cylinder Extrusion Our Experience and Approach

Habashy, E, Bonakdar Hashemi, M, Kohler, T

Corporotomy technique, Revision surgery, Retained rear tip, Penile implant

A 72-year-old man with a history of coronary artery disease, chronic kidney disease, and diabetes mellitus presented for evaluation. The patient had previously undergone implantation of a two-piece inflatable penile prosthesis (IPP) in 2014, which subsequently malfunctioned.

Our surgical video demonstrates our standard approach to IPP revision, including corporal exposure, distal corporotomies for cylinder removal, and closure using long-acting sutures to prevent future complications. Historically, performing a corporotomy at the cylinder exit tubing may result in a difficult to close proximal corporotomy. We also showcase our management strategy when encountering a retained rear tip during the procedure.

The video effectively illustrates our surgical techniques during IPP revision procedures and incorporates our findings regarding postoperative cylinder extrusion cases. Our approach of utilizing distal corporotomies combined with long-acting absorbable sutures for corporotomy closure was specifically developed to minimize the risk of cylinder extrusion, based on our clinical experience with this complication. Since filming we have also added one 2-0 Ethibond across the center of the new corporotomy. Heroic efforts to remove retained material in the absence of clinical infection may not be necessary.

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