Shaeer's Corporotomy Technique II: The Transverse Corporotomy for Inflatable Penile Prosthesis Implantation

O. Shaeer

inflatable penile prosthesis; inflatable penile implant; horizontal corporotomy; transverse corporotomy

Corporotomy for inflatable penile prosthesis implantation has always been longitudinal, along the corpora cavernosa, around 2cm long [1]. Corporotomy is a potential source for hematoma formation [2]. Although suturing corporotomies watertight is more hemostatic, many implanters prefer to tie preplaced stay sutures to avoid needle puncture of the cylinders [2].

We demonstrate Shaeer's Corporotomy Technique, where the corporotomy is cut transversely. Length is mostly less than 1cm. In addition to being minimally invasive, the corporotomy is easier to close by suturing. If stay sutures will be tied over, distributing the knots over a shorter distance of corporotomy decreases the gaps in between. This possibly obviates the need to discharge the patient with the cylinders semi-inflated as an internal tamponade. The shorter length possibly decreases the possibility of cylinder herniation.

Through a peno-scrotal incision, layers are dissected down to the tunica albuginea. Corporotomies are cut transversely less than 1cm long, as proximal as possible. Dilatation and measurement are performed with each pass of the Furlow tool. The cylinders are implanted, proximal end first. The corporotomies are closed either by tying the pre-placed stay sutures, or by suturing watertight with the implant deflated and stretched straight by pulling on the guiding threads. Suturing is relatively safer, considering the shorter corporotomy length and the transverse orientation. This is in comparison to the longer longitudinal corporotomy, where suturing is performed across the longitudinal folds of the deflated cylinder. Test inflation and deflation is performed. If no bleeding issues from the corporotomies in the deflated state, the deflated state is maintained. The reservoir is implanted, pump inserted, system connected and layers closed to the skin.

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1. Al-Enezi, A., S. Al-Khadhari, and T.F. Al-Shaiji, Three-piece Inflatable Penile Prosthesis: Surgical Techniques and Pitfalls. J Surg Tech Case Rep, 2011. 3(2): p. 76-83.

2. O'Rourke, T.K., Jr., et al., Prevention, identification, and management of post-operative penile implant complications of infection, hematoma, and device malfunction. Transl Androl Urol, 2017. 6(Suppl 5): p. S832-s848.