Abstract Introduction Penile prosthesis implantation is an effective surgical treatment for erectile dysfunction refractory to medical therapy. However, postoperative infection remains one of the most challenging complications, often necessitating device explantation. Re-implantation after prior infections poses significant surgical difficulties due to corporal fibrosis, tissue loss, and a higher risk of reinfection. Objective To present a case of successful re-do inflatable penile prosthesis (IPP) implantation in a patient with a history of multiple prior prosthesis infections and severe corporal fibrosis, and to highlight the technical considerations and surgical outcomes. Methods A 33-year-old male with a ten pack-year smoking history and no other comorbidities had previously undergone two prosthesis implantations: an initial three-piece IPP in September 2023, explanted in November 2023 due to infection, and a malleable prosthesis implanted in December 2023, which was also removed one month later for recurrent infection. In April 2024, re-implantation was planned using a Narrowbase Coloplast prosthesis. Preoperative examination revealed a small penile fistula related to prior surgeries. Through a longitudinal penoscrotal incision, extensive corporal fibrosis was encountered. To enable cylinder placement, both corpora cavernosa were incised at three separate levels. A lateral penile curvature identified intraoperatively was corrected using a Nesbit procedure. Results The patient recovered uneventfully. At the one-year postoperative follow-up, the prosthesis was functioning satisfactorily with no evidence of pain, infection, erosion, or mechanical failure. Conclusions Re-do penile prosthesis implantation following infection is a complex and technically demanding procedure requiring surgical expertise and meticulous intraoperative management. Adequate exposure of the corpora cavernosa via a longitudinal penoscrotal or circumferential incision is essential. Narrowbase or CX-R type prostheses are suitable options for patients with fibrotic corporal tissue. Despite advances in technique and prosthesis design, the success rate of re-do implantations remains lower than that of primary procedures, averaging around 80%. Disclosure No
Gürcan et al. (Mon,) studied this question.
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