V04-11: Infected Inflatable Penile Prosthesis Removal and Semi Rigid Prosthesis Insertion
Unfortunately, the presentation of patients with infected Inflatable Penile Prosthesis (IPP) is not rare. Great advances in this field were achieved with development of better surgical technique and prosthetic material but every high-volume surgeon in this field has or will face a patient with an infected IPP. We present a video of our technique for salvage on a patient with and infected IPP, using a Semi Rigid Penile Prosthesis (SRPP).
The video presents a case of a 40 years old gentleman who developed infection of an inflatable penile prosthesis after one month of insertion. Upon discussion with the patient, he elected to undergo a SRPP savage procedure.
The technique used by our service for salvage of an infected inflatable penile prosthesis and insertion of a semi rigid prosthesis is demonstrated: All the surgical steps are well documented and described, demonstrating the procedure in the smallest details. A single standard penoscrotal approach is used, with distal corporotomies. Special attention is given to the surgical preparation and the salvage washout steps, using a technique based on the well known Mulcahy washout. In this particular case, a SRPP was used upon patient's request, but a new IPP might be placed. We also demonstrate his future decision to switch back to an IPP and how important is the salvage procedure in order to maintain penile length.
There is vast literature to support the safety of Salvage procedures in the setting of an infected IPP. Our video attempts to present a simple and easily reproducible technique for this procedure. Progress is being made in this field in order to achieve minimal infection rate but having a safe salvage procedure is fundamental for preservation of penile length and future sexual quality.