To examine possible etiology and treatment outcomes in 21 patients with glans necrosis following penile prosthesis implantation.
Glans necrosis typically presented with a dusky glans on the first postoperative day following prosthesis implantation.
The blood supply to the glans penis consists of the dorsal arteries and the terminal branches of the spongiosal arteries. Using the cohort in our study, we compiled preoperative comorbidities and adjunctive surgical maneuvers that might compromise glans vascularity, leading to glans necrosis. Preoperative risk factors were arteriosclerotic cardiovascular disease (90%), diabetes mellitus (81%), smoking (81%), previous prosthesis explantation (57%), and previous radiation therapy (48%). The most prevalent intraoperative and postoperative factor was subcoronal incision for reasons as simple as coincident circumcision or as complex as for penile degloving (86%). Other factors detected were penile wrapping with an occlusive elastic bandage (62%), use of a sliding technique for penile lengthening (33%), and coincident distal urethral injury repair (29%). Seventeen patients (81%) managed expectantly with preservation of implanted prosthesis sustained significant glandular loss. Four patients managed with immediate prosthesis removal healed without sequelae.
Patients with preoperative risk factors undergoing penile prosthesis implantation should avoid high-risk adjunctive surgical maneuvers. Upon development of signs of glans necrosis postoperatively, in the setting of these high-risk factors, immediate implant removal may prevent subsequent glans necrosis.
Wilson SK, Mora-Estaves C, Egydio PH. Glans Necrosis Following Penile Prosthesis Implantation: Prevention and Treatment Suggestions. Urology. 2017 Sep;107:144-148.
MD, PhD, Dedicado no Tratamento da Doença de Peyronie, Pênis Curvo e Implante de Próteses Penianas. Doutor em Urologia pela USP, CRM 67482, RQE 19514. - Vencedor do Debate do Sobrevivente da AUA em 2019.
Reconstrução peniana, tamanho e calibre do pênis - Kyoto - 2018
Este é um tema muito conhecido pela comunidade médica, que está tornando-se mais popular entre os homens que buscam tratamentos avançados para o pênis, a fim de solucionar condições como a Curvatura ...
MUST Technique for Penile Length and Girth Restoration - JSM 2018
Patients with severe erectile dysfunction (ED) and penile size issues, especially seen in Peyronie's disease (PD), are candidates for more invasive penile prosthesis insertion techniques that aim for ...