The Advanced Fork Dilator “The Fork Furlow” Insertion Tool for Synchronized IPP Cylinder Placement

Ragheb, A

IPP, Fork, Furlow, dilator, crossover, perforation

The Fork Furlow is a novel, multifunctional instrument designed to optimize inflatable penile prosthesis implantation (IPPI) by enabling synchronized corporal dilation, sizing, Keith needle deployment, and cylinder placement in minimal steps. This approach aims to reduce the risk of complications, including corporal crossover, crural perforation, urethral violation, and device compromise. The Fork Furlow was utilized in 20 virgin IPPI cases, with tine positions adjusted based on intercorporal distance to ensure precise alignment. After passing the Fork proximally to the pubic ramus, it is flipped upward and advanced distally to safely reach the corpora's distal tips, completing dilation while recording proximal and distal dimensions. For cylinder placement, both Keith needles are threaded and mounted onto the Fork Furlow to be deployed in a synchronized manner using the double-arm obturator. This method ensured well-aligned dilation and secure cylinder placement, minimizing complications and achieving efficient, successful IPPI. By integrating multiple functions into a single device, the Fork Furlow has the potential to serve as an all-in-one tool, akin to a Swiss Army knife, for safe and effective IPPI in virgin cases. A comparative study with conventional dilation techniques is recommended to further validate these promising results and establish the Fork Furlow as a valuable addition to the prosthetic urology armamentarium.

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