(339) Inflatable Penile Prosthesis Insertion in Cis Male Patient Affected by Exstrophy–Epispadias

Abstract Introduction Patients with the bladder exstrophy–epispadias complex (BEEC) present unique challenges in reconstructive urology. While phalloplasty can restore genital appearance and function, achieving satisfactory erectile function remains complex. The radial forearm free flap (RFFF) phalloplasty is a commonly employed technique in these cases. However, the absence of native erectile tissue necessitates innovative approaches to inflatable penile prosthesis (IPP) implantation. Objective To demonstrate the surgical technique and outcomes of single-cylinder IPP implantation using a Dacron cap in a cisgender male patient with BEEC who underwent RFFF phalloplasty. Methods A 42-year-old cisgender male with a history of BEEC underwent RFFF phalloplasty. At the time of phalloplasty, a urinary sphincter and rear tip extender (RTE) were already inserted. Approximately 10 years later, the patient underwent IPP implantation using a single-cylinder prosthesis. A Dacron cap was created to provide structural support to the tip of the cylinder. The IPP cylinder was inserted, and the pump and reservoir were placed in the scrotum and abdomen, respectively. Results The procedure was completed without intraoperative complications. At 3 years follow-up, the patient reported satisfactory erectile function, achieving sufficient rigidity for penetrative intercourse. There were no signs of infection, extrusion, or mechanical failure. Conclusions Single-cylinder IPP implantation using a Dacron cap is a safe and effective option for restoring erectile function in cisgender male patients with BEEC following RFFF phalloplasty. This technique addresses the challenges posed by inserting a erectile device in a phalloplasty and provides a functional solution for sexual function. Disclosure No