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118 Intracorporeal perforation during penile implantation

Suks Minhas

Intracorporeal perforation during penile implantation is a relatively common but difficult problem to manage. The key points in trying to avoid this are to anticipate when the situation may arise. In this context, patients who have a fibrotic penis, in particular those who are post priapism, have Peyronie’s disease or had a previously infected implant will be at increased risk of perforation.

The key is to try and recognise perforation during implantation. If the dilation is particularly difficult then try and avoid this by ensuring that you have adequate exposure of the area. My normal incision is usually a penile-scrotal incision, but I always warn the patient with a potentially fibrotic penis that we will need to make a further incision circumferentially distally in the case of perforation, or if a difficult dilation is anticipated. When dilating for intracorporeal fibrosis, ensure that your left hand pushes the scissors or dilator towards you, as often there is a tendency during dilation to push the scissors towards the neurovascular bundle and hence perforation can occur.

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