Use of the Otis Urethrotome to facilitate preimplantation of cylinders into scarred corporal bodies

VJPU 2017; 2: 102

Title: Use of the Otis Urethrotome to facilitate reimplantation of cylinders into scarred corporal bodies

Author(s): Koenraad van Renterghem

Key words: infected penile implant, revision penile implant.

In this video a reimplantation of an Inflatable Penile Implant (IPP) is demonstrated in a patient who underwent previously an explant because of infection. Three years earlier patient was operated for a localised prostate cancer with an open retropubic prostatectomy in another institute.  Two years later he was implanted with a IPP in the same hospital. The size of the cylinders was quite different comparing the right side to the left ( right side 19 cm; left side 13 cm). One week post-operatively there was a revision necessary due to a “collection”, another week later he was explanted because of an infected IPP. Three months after explant he underwent a uneventful reimplantation at our institute. We used a penoscrotal access, fibrosis was treated with extensive dilation with Rossello  dilators and using the Otis urethrotome. A symmetrical 18 + 3 cm Titan IPP was implanted, the reservoir was placed high submuscular on the right side and filled with 60 cc. This case demonstrates that high volume centres should take care of penile implant surgery since revision surgery has a worse outcome. The incidence of reoperation is highest in the first year after implantation.

Acknowledgements: Educational grant from Coloplast.

Disclosures: consultant for Coloplast, Boston Scientific.

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