Penile prosthesis in severe corporal fibrosis: a history of a difficult case using the double corporotomy incision technique


  • Dechapol Buranapitaksanti Navavej International Hospital, Bangkok, Thailand



Penile prosthesis, corporal fibrosis, double corporotomy


Penile prosthesis implantation in corporal fibrosis is a significant surgical challenge even for experienced surgeons. As it is a rare occurrence, a small number of series with limited follow-up have been reported. Multiple surgical approaches to eliminate fibrous tissue and to place an implant have been described. In this report, a 48-year-old man had a history of delayed treatment priapism with no response to any erectile dysfunction treatment. Penile prosthesis was recommended but the surgical approach was difficult and complex. It is widely accepted that implanters have to deal with both a high complication rate and patient expectation. This article introduces a new surgical approach in this challenging case.


El-Bahnasawvy MS, Dawood A, Farouk A. Low-flow priapism: risk factors for erectile dysfunction. BJU Int 2002;89:285-90.

Montague DK, Angermeier KW. Corporeal excavation: new technique for penile prosthesis implantation in men with severe corporeal fibrosis. Urology 2006;67:1072-5.

Shaeer O. Penoscopy: optical corporotomy and resection for prosthesis implantation in cases of penile fibrosis, Shaeer’s technique. J Sex Med 2007;4:1214-7.

Tsambarlis PN, Chaus F, Levine LA. Successful Placement of Penile Prostheses in Men With Severe Corporal Fibrosis Following Vacuum Therapy Protocol. J Sex Med 2017;14:44-6.

Henry GD, Donatucci CF, Conners W, Greenfield JM, Carson CC, Wilson SK, et al. An outcomes analysis of over 200 revision surgeries for penile prosthesis implantation: a multicenter study. J Sex Med 2012;9:309-15.

Gross MS, Phillips EA, Balen A, Eid JF, Yang C, Simon R, et al. The Malleable Implant Salvage Technique: Infection Outcomes after Mulcahy Salvage Procedure and Replacement of Infected Inflatable Penile Prosthesis with Malleable Prosthesis. J Urol 2016;195:694-7.

Krughoff K, Bearelly P, Apoj M, Munarriz NA, Thirumavalavan N, Pan S, et al. Multicenter surgical outcomes of penile prosthesis placement in patients with corporal fibrosis and review of the literature. Int J Impot Res 2022;34:86-92.

Wilson SK, Terry T, Delk JR. Improved implant survival in patients with severe corporal fibrosis: A new technique without necessity of grafing. J Urol 1995;153:359A.

Sansalone S, Garaffa G, Djinovic R, Antonini G, Vespasiani G, leria FP, et al. Simultaneous total corporal reconstruction and implantation of a penile prosthesis in patients with erectile dysfunction and severe fibrosis of the corpora cavernosa. J Sex Med 2012;9:1937-44.




How to Cite

Buranapitaksanti, D. (2022). Penile prosthesis in severe corporal fibrosis: a history of a difficult case using the double corporotomy incision technique. Insight Urology, 43(2), 167–70.



Case Report