Shaeer's Anti-Scarring Technique: A Preventive Measure Against Corporal Fibrosis Upon Explantation of Infected Penile Implants

Osama Shaeer; Islam Fathy Soliman Abdel Rahman; Kamal Shaeer

doi:10.1016/j.esxm.2019.06.002

Shaeer's Anti-Scarring Technique: A Preventive Measure Against Corporal Fibrosis Upon Explantation of Infected Penile Implants

Sex Med. 2019 Sep;7(3):357-360. doi: 10.1016/j.esxm.2019.06.002. Epub 2019 Jul 8.

Authors

Osama Shaeer¹, Islam Fathy Soliman Abdel Rahman², Kamal Shaeer²

Affiliations

¹ Department of Andrology, Kasr El Aini Faculty of Medicine, Cairo University, Cairo, Egypt. Electronic address: dr.osama@alrijal.com.
² Department of Andrology, Kasr El Aini Faculty of Medicine, Cairo University, Cairo, Egypt.

Abstract

Introduction: In cases of explantation and delayed reimplantation of an infected penile prosthesis, the scarring that afflicts the corporal bodies renders reimplantation difficult and risky, with potential loss in penile size.

Aim: Mitomycin C is an antitumor, antibiotic agent with a potent antifibrotic action that can be used to limit corporal scarring following explantation with the aim of achieving easy and safe subsequent reimplantation, in addition to preserving penile size.

Methods: This was a prospective study involving 5 patients with infected penile prostheses who were referred to our tertiary implantation center. The infected prostheses were explanted, followed by corporal washout with antiseptics and antibiotics. Patients were rescrubbed and redraped. Mitomycin C, 10 mg in 250 cc saline, was instilled into the corpora cavernosa (125 cc each), avoiding extracavernous spilling and contact with corporotomy and skin edges. Corporotomy and skin edges were freshened and closed. Reimplantation was performed 10 to 12 weeks later.

Main outcome measure: We evaluated the ease of blunt dilatation upon reimplantation and success in implanting cylinders the same size as the ones explanted.

Results: We were able to dilate the corporal bodies with ease in all cases using blunt Hegar dilators. All cases received the same size implant as the one explanted, in terms of length and girth, with the exception of a case where the length was only 1 cm shorter.

Conclusions: Irrigation of the cavernous spaces with mitomycin C upon explantation of an infected penile prosthesis appears to ameliorate corporal scarring and keep the cavernous spaces open. On a larger scale, this approach could render the most feared complication of penile prosthesis implantation surgery much more manageable. Shaeer O, Abdel Rahman IFS, Shaeer K. Shaeer's Anti-Scarring Technique: A Preventive Measure Against Corporal Fibrosis Upon Explantation of Infected Penile Implants. Sex Med 2019; 7:357-360.

Keywords: Corporal fibrosis; Corporal scarring; Delayed reimplantation; Penile implant extrusion; Penile prosthesis infection; Salvage.