MANAGEMENT OF IMPENDING PENILE PROSTHESIS EROSION WITH A POLYTETRAFLUOROETHYLENE DISTAL WIND SOCK GRAFT

Purpose: Erosion of penile prostheses can be calamitous, often leaving patients unable to accommodate further implants. There is a paucity o f literature describing impending erosion of penile prosthesis. We rep ort on 5 patients with impending erosion of a penile prosthesis who un derwent polytetrafluoroethylene distal wind sock graft placement. Mate rials and Methods: From 1993 to 1997, 5 patients with a mean age of 49 years and impending penile prosthesis erosion underwent 6 revisions u sing a polytetrafluoroethylene distal wind sock graft. Two patients un derwent simultaneous bilateral grafts while 1 patient underwent separa te right and left grafts 3 years apart. Indications for reconstruction included distal migration of the prosthetic cylinders into the glans in 4 patients and impingement of the distal urethra in 2. Of the patie nts 3 were spinal cord injured, 1 had lumbar radiculopathy and 1 had a history of pelvic irradiation. Inflatable prostheses were implanted i n 4 patients, while 1 received a malleable prosthesis. Results: Patien ts underwent a mean of 1.5 penile prosthetic revisions (0 to 4) before diagnosis of impending erosion. An interval of 8 to 144 months (mean 66) elapsed from the most recent penile prosthesis insertion until dis tal wind sock graft placement. Mean operative time was 1 hour 51 minut es (1.3 to 2.5 hours). Mean hospital stay was 6.3 days (3 to 12). At a mean followup of 32 months (0.7 to 5.2 years) all patients had satisf actory and functional erections with no pain or evidence of impending erosion or penile prosthesis infection: Conclusions: Erosion of a peni le prosthesis can have disastrous consequences. We describe a safe and effective technique for managing impending penile prosthesis erosion using a polytetrafluoroethylene distal wind sock graft.