Prevention of urethral stricture in insertion of an inflatable penile prosthesis

Abstract

Objective: The aim of this study was to find the mechanism that causes urethral stricture with a view to preventing its occurrence after implantation of a three-piece inflatable penile prosthesis. Methods: When implanting a three-piece inflatable penile prosthesis, we draw two longitudinal lines parallel to the long axis of the proximal cylinder and the tubing leading from each cylinder into the cavernosal space, to prevent 360 degree rotation of the cylinder. Results: From September 1993 to February 2007, a total 86 three-piece penile prosthesis implantations were carried out in 70 patients. Urethral stricture occurred in 5.8% (5/86) of the prosthesis operations. Fifteen three-piece penile prosthesis reinsertions were carried out in 17.4% (15/86) of the prosthesis recipients. Conclusions: A successful outcome was achieved in the patients who received penile implantation with the three-piece penile prosthesis that were marked with longitudinal lines. The rotation of the cylinder may cause compression on the urethra from the tubing leading from the cylinder or pump crossing over the urethra and resulting in urethral stricture. The drawing of longitudinal lines at the proximal cylinder and tubing leading from the cylinder could prevent the urethral stricture induced by tubes that are twisted by rotation of the cylinder.

Editorial Comment

“…Authors described a high complication rate of urethral stricture of 5.8%, although infection has not occurred, hence, authors should add an explanation for the current high complication rate. The events reported in this article 3 are extremely rare and have not been reported by any other institutions.…”

An Unusual Success with Simultaneous Urethral Repair and Reimplantation of Penile Prosthesis in a Patient with Urethral Stricture Induced by Rotated Tubing

“…To overcome the abnormal rotation, we marked two longitudinal lines on the surface of the cylinder and tubings leading from the cylinders before the insertion of cylinder of TPIPP [9].…”

“…After urethroplasty, new cylinders and pump were placed in cavernosal spaces and intra-scrotum in a routine manner, respectively ( Figure 2B). We have drawn two longitudinal lines on the cylinder and tubings leading from cylinder to prevent the abnormal rotation of the cylinder [9]. Intraoperative antibiotic irrigation (gentamycin and vancomycin) was performed in all procedures.…”

“…The urethral stricture after implantation of a TPIPP is rare by compression of twisted tubing's which has occurred to the patient with a TPIPP [9]. Unfortunately, the urethral stricture has been severely aggravated, and complicated operations should be needed as time has passed.…”

Mechanism of Penile Prosthesis Induced Urethral Stricture: Treatment and Prevention

“…Urethral stricture after implantation of a three-piece inflatable penile prosthesis is very rare but has been reported in 2007 [10]. Urethral stricture was induced by compression of twisted tubing in three-piece inflatable penile prosthesis and it would be aggravated with the lapse of time [11].…”