BUCKLING OF CYLINDERS MAY CAUSE PROLONGED PENILE PAIN AFTER PROSTHESIS IMPLANTATION - A CASE-CONTROL STUDY USING MAGNETIC-RESONANCE-IMAGINGOF THE PENIS
I. Moncada et al., BUCKLING OF CYLINDERS MAY CAUSE PROLONGED PENILE PAIN AFTER PROSTHESIS IMPLANTATION - A CASE-CONTROL STUDY USING MAGNETIC-RESONANCE-IMAGINGOF THE PENIS, The Journal of urology, 160(1), 1998, pp. 67-71
Purpose: We identify risk factors associated with chronic postoperativ
e penile pain after inflatable prosthesis insertion. Materials and Met
hods: We performed a case control study to determine the incidence of
prolonged penile pain in 65 men who underwent prosthesis insertion. Th
e association of various potential risk factors, including diabetes me
llitus, incision site, prosthesis type, patient age and history of pel
vic surgery, was assessed. In addition, the penis was examined for phy
sical findings, and penile magnetic resonance imaging (MRI) was done a
s an in situ evaluation of the anatomical position and functional stat
us of the inflatable prosthesis. Results: A total of 14 patients (21.5
%) with prolonged pain were compared to the remaining 51 with no pain.
All parameters evaluated were similar in both groups except for MRI f
indings. Of the 14 patients with pain 12 (85.7%) had buckling of the c
ylinders in the flaccid state compared to only 1 of the 51 controls (1
.9%). Statistical analysis showed a highly significant association bet
ween buckling and penile pain (odds ratio 300, p <0.0001). Surgical co
rrection of buckling resolved pain in 5 patients. Conclusions: Prolong
ed postoperative penile pain after prosthesis insertion is strongly as
sociated with cylinder buckling. This buckling may be the consequence
of an excessively long cylinder or an appropriate size cylinder that f
ails to reach the crural end. The method of accurately diagnosing thes
e alterations is MRI of the penis.