What question did this study set out to answer?

To describe the management of distal extrusion of an AMS 700 LGX hydraulic prosthesis, emphasizing preservation and infection control.

June 6, 2026

(479) Management of Distal Extrusion of a Penile Implant by Retrocapsular Repositioning, and Polypropylene Mesh Reinforcement

Key Points

To describe the management of distal extrusion of an AMS 700 LGX hydraulic prosthesis, emphasizing preservation and infection control.
Case report of a 69-year-old male post-prostatectomy with distal extrusion.
Interventions included retrocapsular repositioning, polypropylene mesh reinforcement, and a seven-step antibiotic irrigation protocol.
Diagnosis involved cystoscopy, revealing minimal extrusion and accompanying procedures.
Postoperative recovery was uneventful, with the Foley catheter removed on day five.
The prosthesis activation occurred at four weeks, demonstrating optimal functional outcomes.
No evidence of infection was observed at three months post-surgery.

Abstract

Abstract Introduction Distal extrusion of a penile prosthesis is an uncommon complication that poses a significant surgical challenge, particularly in oncologic patients with penile fibrosis. Management should be individualized, prioritizing implant preservation, infection control, and patient preference. Objective To describe the management of a case of distal extrusion of an AMS 700 LGX hydraulic prosthesis with InhibiZone™, treated through subcoronal corporoplasty, retrocapsular repositioning, and polypropylene mesh reinforcement, combined with a seven-step antibiotic irrigation protocol according to Mulcahy. Methods A 69-year-old male with a history of prostate adenocarcinoma (Gleason 4+4), treated with laparoscopic radical prostatectomy in 2021, underwent AMS 700 LGX implantation in August 2024. Intraoperatively, distal fibrosis and a 1-mm perforation of the right corpus cavernosum were identified and repaired. Nine months later, he presented with right distal-lateral penile pain during intercourse, without urethral bleeding or signs of infection. Cystoscopy revealed minimal (1 mm) extrusion of the right cylinder into the navicular fossa. Subcoronal corporoplasty, retrocapsular repositioning, polypropylene mesh reinforcement, and Mulcahy’s seven-phase antibiotic irrigation were performed. Results The procedure was uneventful. The Foley catheter was removed on postoperative day five, and the prosthesis was activated at four weeks, achieving optimal functional outcomes with no evidence of infection at three months. Conclusions In selected cases of distal penile prosthesis extrusion occurring within the first postoperative year and without local infection, retrocapsular repositioning reinforced with polypropylene mesh and Mulcahy’s antibiotic irrigation protocol represents a valid and safe alternative. This approach allows for preservation of the hydraulic device and avoids conversion to a malleable prosthesis or additional surgeries. Disclosure No

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