Mp48-13 National Trends in Penile Prosthetic Surgery: The Effect of Inhibizone

Abstract

early distal cancers to be treated whilst preserving function and cosmesis. Some patients, however, may require more than the glans to be removed and less attention has been given to the outcomes in partial penectomy. We have refined this operation to give the penile stump a normal looking neo-glans whilst maximising length.Traditionally, in partial penectomy, the cut ends of the corpora are closed leaving the erectile bodies and urethra separate. In this new technique the corpora cavernosa are left open and wrapped, either partially or completely, around the urethra to centralise it into its normal position. This can be facilitated by a small ventral incision of the corporal tunica if need be. Haemostasis is provided by diathermy to the corporal arteries and tamponade of the erectile tissue against the urethra. A split skin graft is applied to the head of the remaining penis to create a neo-glans with a normally situated urethral meatus. Avoidance of corporal closure gives a slight length advantage and Buck's fascia provides a good surface for grafting resulting in a surprisingly normal appearance to the penis.The objectives are to review the complications and present, by diagrams and photographs, the surgical technique and cosmetic outcomes.METHODS: Men with T2/3 tumours who underwent UCAPP from January 2003 to October 2014 were identified and their records analysed.RESULTS: 14 patients underwent UCAPP from January 2003 to October 2014. 13 patients had squamous cell carcinomas and one a leiomyosarcoma. The mean age of our cohort was 67 years (52-88). One patient had 50% loss of the split skin graft but this healed without further surgery and the remaining patients did not have any procedurespecific complications. One patient required completion penectomy due to local disease recurrence. The mean follow up time was 62 months (6-147 months), although 4 patients died during this time as a result of metastatic disease.CONCLUSIONS: This technique creates a normally shaped neo-glans after partial penectomy. It is a small refinement but one which can significantly improve the overall appearance and hence reduce the psychological trauma of this devastating disease.