Reconfiguration of the severely fibrotic penis with a penile implant

Purpose: Using evidence based methods we prospectively evaluated the impact of a new surgical procedure on penile deformity caused by severe cavernous fibrosis. Materials and Methods: In 10 patients with severe penile curvature, shorten ing and impaired penile rigidity due to fibrosis of the corpora cavernosa w e made multiple relaxing incisions of the tunica albuginea and subsequently placed a 3-piece inflatable penile implant. Patients were evaluated before and after the procedure by the International Index of Erectile Function an d several general assessment questions. Preoperatively and postoperatively we measured flaccid and erect penile length. Results: At the 6-month followup all International Index of Erectile Functi on domains were significantly improved compared with preoperative values. A verage penile length was increased 2.3 and 3 cm. while flaccid and erect, r espectively, compared with before surgery. Complete penile straightening wa s achieved in 9 of 10 cases (90%). Surgical reoperation was performed in 1 patient (10%) in whom the implant was removed due to scrotal infection and in another (10%) in whom a further single relaxing incision of the fibrotic plaque was needed to attain complete penile straightening. Conclusions: Patients with severe penile curvature, shortening and impaired penile rigidity due to penile fibrosis may be offered this surgical altern ative, which proved to be effective and safe in our preliminary series.