USE OF A PREFABRICATED TUNICA VAGINALIS FASCIA FLAP TO RECONSTRUCT THE TUNICA ALBUGINEA AFTER RECURRENT PENILE PROSTHESIS EXTRUSION

Purpose: Although a penile prosthesis usually perforates into the uret hra, it can extrude through the glans or corporeal shaft. Various mate rials have been used to reconstruct tunica albuginea but no method of repair has been satisfactory in such difficult cases. Repair of the we akened tunica albuginea should ideally be performed with autogenous ti ssues. Inasmuch as the scarred tissue bed is inadequate to ensure graf t survival and no local flaps are available for this purpose, prefabri cation of a local flap has been designed. Materials and Methods: We pr esent 2 cases in which the distal corpus was reconstructed with a pref abricated tunica vaginalis fascia flap. The first stage involves graft ing rectus fascia onto the external tunica vaginalis of the testicle. At the second stage the prefabricated tunica vaginalis fascia flap is transposed to the distal corpus, placing it as a buttress between the cylinder and urethra medially or between the cylinder and thin lateral and distal tunica albuginea. The flap also replaces part of the tunic a albuginea. Results: In both patients repair of the tunica albuginea was successful and each has a functioning inflatable penile prosthesis at 2 1/2 1 1/2 years postoperatively, respectively. Conclusions: Reco nstruction of the weak tunica albuginea with a prefabricated tunica va ginalis fascia flap is an excellent procedure in these difficult cases .