(405) Penile Prosthesis Implantation and Peyronie's Disease: How to Approach the Residual Curvature – A Detailed Demonstration of Moulding Technique and Grafting Procedure

Abstract Introduction Insertion of a penile prosthesis is the treatment choice in men with Peyronie’s disease and concomitant erectile dysfunction. The aim surgery to straighten penis allow adequate rigidity for sexual intercourse. A conundrum arises when there residual curvature during device testing. Objective This video highlights strategies that will aid implanter faced these intraoperative challenges. Methods illustrates three different scenarios suggests can be used following inflatable insertion: 1) Manual moulding – In this scenario, persistent left lateral successfully straightened by plaque insertion. cylinders are fully inflated tubes pump double clamped. One hand positioned distal apex while other proximal. manipulated opposite direction curvature. 2) Residual after manual incised at point maximal grafted If significant (>30 degrees) moulding. fibrin sealant patch was patient it offers quick effective grafting tunical defect. 3) Upfront incision - Some patients not suitable Examples include ventral ossified plaques. curvature, defect bovine pericardial graft prior corporal dilatation. Results All had an uneventful post-operative outcome. They were encouraged cycle from 3 weeks allowed commence intercourse 6 post-surgery. Conclusions safe first line option Plaque considered if fails or where contraindicated. There several choices material including pericardium. Disclosure No