Habashy, E.

ABSTRACT Introduction The inflatable penile prosthesis (IPP) is a widely accepted surgical treatment for refractory ED. It has the highest satisfaction rates of all ED treatment modalities; however, 7-8% of patients will require reoperations. Mechanical failure, infection, erosion, and extrusion are some of the common indications for reoperations. Objective Our video highlights our IPP revision approach that is aimed to lower the risk of future cylinder extrusion/displacement. We also share a rare case of a retained rear tip during device explanation. Methods Our video demonstrates our standard technique of obtaining corporal exposure, performing distal corporotomies to explant the cylinders, and utilizing long-acting sutures to prevent future device extrusion. We also demonstrate an encounter with a retained rear tip and our management approach in that scenario. Results Our video successfully demonstrates our intraoperative techniques and surgical approach during IPP revision procedures. It also highlights our experience with postoperative cylinder extrusion from 2017-2021. Conclusions Our surgical approach during IPP revision using distal corporotomies and long-acting absorbable sutures for corporotomy closure aims to reduce the risk of potential cylinder extrusion. The technique was developed based on our own experience with this complication. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Dr. Kohler is a consultant for Coloplast

ABSTRACT Introduction Glanular hypermobility (GH) or supersonic transporter (SST) deformity are occasionally encountered during or after penile prosthesis (PP) implantation. The “frozen pump” is a phenomenon that patients experience postoperatively where they encounter difficulty inflating the device due to a rigid capsule formation around the pump leading to pump failure. Objective In our video we describe our surgical approach in the management of GH, and the Frankenstein technique we utilize to address a "frozen pump". Methods Our video demonstrates our standard technique of using permanent sutures to repair GH with bilateral distal dorsal anchoring sutures and a deep glans suture. It also demonstrates our Frankenstein pump revision technique where a different brand device component may be utilized to replace the original device pump to ease device inflation. Results Successful repair of GH/SST deformity and revision of a non-functioning PP pump. Conclusions Glanulopexy with permanent suture successfully corrects severe GH or SST in men with inflatable PP. Using different brand components to revise PP pump can be done without compromise to mechanical function. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Tobias Kohler is consultant for Coloplast