Late complications of spontaneous urethral erosion of malleable penile prosthesis in a young patient

INTRODUCTION Most men with erectile dysfunction are initially offered systemic therapy with a phosphodiesterase type 5 inhibitor, and then a choice of intracorporeal injection or intraurethral treatment. If these initial treatments fail or are rejected, penile prosthesis implantation is usually the third-line treatment option. The technology for penile prosthesis has been evolving, and it has been in widespread use since the early 1970s.(1) Currently, inflatable penile prosthesis, mostly with an antibiotic coating inside the tunica albuginea, is the preferred choice in the United States.(2) Malleable penile prostheses are semi-rigid and allow the penis to bend downward for dressing and upward for coitus. They have very low mechanical failure and a relatively lower price compared to inflatable penile prostheses, which is a clear advantage, especially for developing countries such as Turkey. However, there are also some known problems such as constant penile rigidity and an increased risk of erosion.(1,2) Urethral erosion of the prosthesis has been reported as a late complication, which may appear any time from several months to 11–20 years after the implantation, mostly due to the indwelling catheter.(3-5) We encountered a case of urethral erosion of the malleable penile prosthesis after 23 years in a 45-year-old patient without any underlying risk factors, including those related to indwelling catheters. To our knowledge, this is the latest case of complications due to erosion of the penile prosthesis.