Treatment of penile fibrosis with prosthetic implantation and flap advancement with tissue debulking.

Abstract

Even after successful penile prosthesis implantation in patients with extensive penile fibrosis, a subset will have insufficient penile length for satisfactory sexual intercourse. We report a combined surgical approach to gain additional functional length in these patients. During the last 18 months 11 patients with extensive cavernous fibrosis underwent penile prosthesis implantation with a modified suprapubic V-Y advancement flap and lower abdominal tissue debulking. After prosthesis implantation the accompanying procedures allowed these patients to gain an additional 3.5 to 6.5 cm. in functional length. All patients had a functional device after a mean followup of 12 months. No prosthesis became infected and no patient required an additional flap procedure. This surgical approach allows patients to gain additional functional length for satisfactory intercourse after treatment of extensive penile fibrosis.