Introduction Implantation of a penile prosthesis in cases of neglected or resistant ischemic priapism, or delayed re-implantation following prosthesis infection and extraction, is usually a difficult and risky procedure due to fibrosis of the corpora cavernosa. Among the common complications are perforation of the urethra, tunica albuginea, and infection. The complications are usually due to the use of blind force against resistance. Aim We propose the techniques of Trans-Corporeal Resection and Optical Corporotomy as adjuvant measures for excavating the fibrosed corpora cavernosa under vision, without the use of force against resistance. Methods Six patients with diffuse fibrosis of the corpora cavernosa were operated on. The instruments and technique are the same as for optical urethrotomy and transurethral resection. Optical Corporotomy was started with, where the corpora are incised from within. After establishment of a satisfactory passage, Trans-Corporeal Resection followed to scrape the fibrous tissue. Implantation of penile prosthesis was completed as usual. The procedure was performed through 1.5 cm incision in the tunica albuginea. Main Outcome Measures Length, girth, and straightness in the erect position, as well as the incidence of complications. Results Operative time was an average of 90 minutes. No difficulty was encountered during the procedure. No complications were noted through 1 year of follow-up. Conclusion Optical Corporotomy and Trans-Corporeal Resection allow for force-free, visually monitored excavation of the fibrosed corpora cavernosa, aiming at safer penile prosthesis implantation.

Introduction The glans penis is prone to mutilation in a handful of conditions, some accidental and others iatrogenic. Deformed functioning remnants of the glans challenge the surgeon's decision. Neither is the glans totally amputated, justifying a neoglansplasty, nor are the remnants cosmetically acceptable, though retaining sensibility and engorgement. Aim In this work, we described the “reconfiguration of the glans penis” whereby deformed glanular tissue remnants can be made into a functional and cosmetically acceptable glans. Methods Five patients with separate mutilated lumps of functioning glanular tissue were operated upon. The lumps were mobilized and flattened into sheets and configured to redrape the summit of the penis, minding their vascular and nerve supply. Main Outcome Measures Cosmetic and functional outcome. Results The outcome was cosmetically acceptable for all patients in comparison to the preoperative state. Conclusion Glans reconfiguration may possibly confer an acceptable cosmetic outlook to a mutilated glans without compromising valuable functional characteristics.