Table 3 Trouble-shooting complications related to inflatable penile prosthesis cylinders
Cylinder-related complications | When to suspect | Strategies to rectify |
|---|---|---|
Crossover | Difficulty in inserting or inflating the contralateral cylinder Uneven penile shape on full inflation of the cylinders | Careful passage of the dilator(s) on the dorsolateral direction Dilating or sizing the affected corpora cavernosa with a stationary dilator maintained in the ipsilateral corporal body |
Distal perforation | Distal dilator tip sits in an unusual location within the glans penis Presence of fluid at urethral meatus during corporal irrigation Abnormal goal-post signa | Abort surgery if urethral injury is suspected or identified A primary closure of distal urethral injury with temporary urethral catheterization A single-cylinder placement on the normal corporal body (contralateral side of urethral perforation) |
Proximal perforation | Discrepancy between both corporal measurements (usually greater than 1.5 cm) Sudden downward passage of the dilator within the proximal corporal body beyond the attachment of the crus to the pelvic bone insertion Abnormal goal-post signa | Placement of a non-absorbable suture in a windsock sling manner at the rear tip extender affixed to the tunica layer at the corporotomy site distal to the exit of the input tubing Fashion a graft material as a covering socket for proximal cylinder body (if the distal tunica is absent or weak) (often not necessary) |
