Use of a wire loop monopolar electrode for open, visual excavation in severe corporeal penile fibrosis before penile prosthesis implantation

Robert Andrianne, Catherine Hubert, Mohamed Ali Ben Chehida, Maxime Sempels, Luc Coppens and David Waltregny

Corporeal fibrosis; penile prosthesis implantation; corporeal excavation

Implantation of a penile prosthesis in severely scarred corporal bodies represents a great challenge. A major dilation of the corpora cavernosa is essential for the placement in an unhindered way a well sized inflatable penile prosthesis in order to get the best length and girth of the penis.

Many techniques have been described (blind dilation or destruction of the fibrosis, multiple cavernotomies, visual excavation); yet they can compromise closure of the corpora cavernosa and limit size, type, and function of the prosthesis.

We have hypothesized that in case of severe fibrosis, a good exposition with a wide, longitudinal excision of the fibrous carvenosal tissues may be an excellent option to restore penile smoothness and obtain the required space for prosthesis implantation. In this video, we present our innovative technique using a wire loop monopolar electrode (KLS-Martin Germany®) for open corporeal excavation.

Through this video surgery, we show that wire loop electrode resection for open, visual corporeal excavation is a feasible, fast and safe technique avoiding the need for grafts. Moreover it allows oversizing PP for better satisfaction.

So far, our technique has been used in 6 patients (with a 3 year follow up) without any complication.

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