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Clinical Summary

Penile implants are typically undertaken when more conservative therapy for erectile dysfunction is either unacceptable to the patient or fails. The two main types are semi-rigid rods, which result in a permanent erection, and inflatable prostheses, which include cylinders placed in the corpora cavernosa and a pump in the scrotum. Erosion rarely can occur months or years after the placement of the prosthesis, and the rods or cylinders can erode through the urethral meatus or the pump and tubes can erode through the scrotum.

Management and Disposition

Any erosion of the device requires complete removal of the device and potential replacement. A urologist should be contacted in the emergency department, although the removal may not be emergent unless an infection is present. Infection may coexist, either as the etiology of the erosion or as a result of the erosion. Antibiotics and more urgent removal are indicated if an infection is present.

Pearls

  1. The inflatable prosthesis typically has cylinders in the corpora cavernosa and the pump in the scrotum.

  2. Any visible erosion of the device requires removal of the device.

  3. Evaluate for concomitant infection as the etiology of or resulting from the erosion.

FIGURE 8.48

Penile Implant Erosion. Inflatable prosthesis from penile implant eroding through the corpora cavernosa and out of the urethral meatus after eroding into the urethra. (Photo contributor: R. Jason Thurman, MD.)

FIGURE 8.49

Penile Implant Erosion. A displaced penile implant with erosion of the pump and tubing through the scrotum is seen. (Photo contributor: Alan B. Storrow, MD.)

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