Endoscopic Retrieval of a Penile Prosthesis' Rear-Tip Extender

Abstract

Introduction The renewal of penile prosthesis is a foreseeable intervention because of the limited survival time of the different implants. It usually becomes necessary simply for material fatigue after long-term regular use; in some cases, premature intervention might be necessary because of infection or other perioperative complications. Aim In the case presented here, the removal of a Dynaflex penile prosthesis showed a missing rear-tip extender on the right-hand tube. Main Outcome Measures and Methods A cavernoscopy of the right cavernous body was performed by using a conventional urethrocystoscope. The found rear-tip extender was extracted by using alligator forceps via the cystoscopic device. Results A new AMS CX hydraulic cavernous body prosthesis was successfully implanted. It has proven fully functional up to the current follow-up control. Conclusions This case shows that cavernoscopy is a gentle intraoperative procedure for diagnosing and removing material in penile prosthesis surgery.

Complications Associated with Retained Foreign Bodies from Infected Penile Implants: Proposal for the Use of an Implant-Specific Checklist at the Time of Device Removal

“…Checklists are widely used in the aviation industry, and serve as a reminder of items required, things to be done, or issues to be considered . While some of the items on a checklist may seem intuitive, the adoption of this methodology in the operating room is now showing great promise in improving patient safety .…”

The Rear Tip Extender for Inflatable Penile Prostheses: Introduction of “Rigidity Factor” and Review of the Literature

“…The most common complication reported with a rear tip is when it is left behind either during revision/ removal surgery or during re-positioning. Many series and case studies have been published regarding methods of RTE removal, including using a nasal speculum, graspers, a Silastic penile measuring rod, a Brooks dilator and cystoscopic (using a cystoscope in the corpora) removal [17][18][19][20][21]. Complete bilateral dislocation of the rear tips has also been reported [22].…”

“…The use of rear tips may also vary by the surgical approach for prosthetic placement. A multi-institutional study showed that penoscrotal approach to prosthesis placement was associated with increased proximal dilation (10.1 cm vs 8.6 cm, P < 0.0001), and resulted in longer RTEs (1.9 cm vs 1.2 cm, P < 0.0001), when compared to infrapubic placement [20]. This difference may be because additional RTEs are added in the penoscrotal approach to place the pump lower in the scrotum.…”

A Review of Surgical Techniques for Impending Distal Erosion and Intraoperative Penile Implant Complications: Part 2 of a Three-part Review Series on Penile Prosthetic Surgery

“…This same author has even used advancement flaps and lower abdominal tissue debulking in those patients with insufficient penile length for satisfactory sexual intercourse [31]. Shaeer has described using a resectoscope to remove the corporal fibrosis scar under direct vision during penoscopy, while other authors have used penoscopy for retrieval of rear tip extenders [40–42].…”