Distal Corporal Anchoring Stitch: A Technique to Address Distal Corporal Crossovers and Impending Lateral Extrusions of a Penile Prosthesis

Gabriele Antonini, Gian Maria Busetto, Francesco Del Giudice, Matteo Ferro, Benjamin I. Chung, Simon L. Conti, Alfredo Suarez Sarmiento, Arianna Pacchiarotti, Ettore De Berardinis, Paul E. Perito

Research output: Contribution to journalArticle

Abstract

Background Unidentified distal crossovers, delayed distal crossovers, and impending lateral extrusion are complications of penile prosthesis implant insertion but are not as common as prosthesis infection or mechanical failure. Aim To evaluate results of a surgical technique, the distal corporal anchoring stitch, that addresses fixation of the penile prosthesis in patients with these complications. Methods A lateral sub-coronal incision is used on the side where the crossover or laterally extruding cylinder should be positioned. Dissection is carried through the Buck fascia, followed by a transverse incision of the tunica albuginea, where the distal aspect of the affected cylinder is delivered. A 4-0 PDS suture is threaded through the distal cylinder ring of the implant. A new, properly positioned intracorporal channel is created and the suture is passed through the distal end of the channel. Once the suture is through the glans and the cylinder is in the correct position, a small cruciate incision is made on the glans at the location of the anchor stitch. The suture is tied with the knot buried in the glans tissue. Outcomes Fifty-three patients underwent treatment of their distal penile implant crossover with a distal corporoplasty using this method and their anatomic and functional outcomes and overall satisfaction were evaluated. Results This technique ensured that the cylinder remained in the newly created, appropriately positioned channel. No patients developed infections, wound-healing defect, glandular hypoesthesia, anesthesia, or altered sensation or pain in the glans related to the suture and only two reported recurrence of a lateral herniation that did not require further treatment. Clinical Implications Distal fixation of the penile prosthesis is a useful surgical adjunct to treating patients with prosthetic lateral extrusions or crossovers that can be applied in almost all cases. Strengths and Limitations Considering these rare complications, our experience is based on a relatively large number of patients and showed a low incidence of complications and a high satisfaction rate. The main limitation of this study is the retrospective nature of the data and the series included patients from two high-volume surgeons that might not be generalizable to all practices. Conclusion The distal corporal anchoring stitch is safe and effective in securing distal fixation of the extruding inflatable penile prosthesis. Antonini G, Busetto GM, Del Giudice F, et al. Distal Corporal Anchoring Stitch: A Technique to Address Distal Corporal Crossovers and Impending Lateral Extrusions of a Penile Prosthesis. J Sex Med 2017;14:767–773.

Original languageEnglish
Pages (from-to)767-773
Number of pages7
JournalJournal of Sexual Medicine
Volume14
Issue number6
DOIs
Publication statusPublished - Jun 1 2017

Fingerprint

Penile Prosthesis
Sutures
Prostheses and Implants
Hypesthesia
Fascia
Infection
Wound Healing
Dissection
Anesthesia
Retrospective Studies
Recurrence
Pain
Incidence
Therapeutics

Keywords

  • Distal Corporal Crossover
  • Impending Lateral Extrusion
  • Penile Prosthesis

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynaecology
  • Urology

Cite this

Distal Corporal Anchoring Stitch : A Technique to Address Distal Corporal Crossovers and Impending Lateral Extrusions of a Penile Prosthesis. / Antonini, Gabriele; Busetto, Gian Maria; Del Giudice, Francesco; Ferro, Matteo; Chung, Benjamin I.; Conti, Simon L.; Suarez Sarmiento, Alfredo; Pacchiarotti, Arianna; De Berardinis, Ettore; Perito, Paul E.

In: Journal of Sexual Medicine, Vol. 14, No. 6, 01.06.2017, p. 767-773.

Research output: Contribution to journalArticle

Antonini, G, Busetto, GM, Del Giudice, F, Ferro, M, Chung, BI, Conti, SL, Suarez Sarmiento, A, Pacchiarotti, A, De Berardinis, E & Perito, PE 2017, 'Distal Corporal Anchoring Stitch: A Technique to Address Distal Corporal Crossovers and Impending Lateral Extrusions of a Penile Prosthesis', Journal of Sexual Medicine, vol. 14, no. 6, pp. 767-773. https://doi.org/10.1016/j.jsxm.2017.04.669
Antonini, Gabriele ; Busetto, Gian Maria ; Del Giudice, Francesco ; Ferro, Matteo ; Chung, Benjamin I. ; Conti, Simon L. ; Suarez Sarmiento, Alfredo ; Pacchiarotti, Arianna ; De Berardinis, Ettore ; Perito, Paul E. / Distal Corporal Anchoring Stitch : A Technique to Address Distal Corporal Crossovers and Impending Lateral Extrusions of a Penile Prosthesis. In: Journal of Sexual Medicine. 2017 ; Vol. 14, No. 6. pp. 767-773.
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abstract = "Background Unidentified distal crossovers, delayed distal crossovers, and impending lateral extrusion are complications of penile prosthesis implant insertion but are not as common as prosthesis infection or mechanical failure. Aim To evaluate results of a surgical technique, the distal corporal anchoring stitch, that addresses fixation of the penile prosthesis in patients with these complications. Methods A lateral sub-coronal incision is used on the side where the crossover or laterally extruding cylinder should be positioned. Dissection is carried through the Buck fascia, followed by a transverse incision of the tunica albuginea, where the distal aspect of the affected cylinder is delivered. A 4-0 PDS suture is threaded through the distal cylinder ring of the implant. A new, properly positioned intracorporal channel is created and the suture is passed through the distal end of the channel. Once the suture is through the glans and the cylinder is in the correct position, a small cruciate incision is made on the glans at the location of the anchor stitch. The suture is tied with the knot buried in the glans tissue. Outcomes Fifty-three patients underwent treatment of their distal penile implant crossover with a distal corporoplasty using this method and their anatomic and functional outcomes and overall satisfaction were evaluated. Results This technique ensured that the cylinder remained in the newly created, appropriately positioned channel. No patients developed infections, wound-healing defect, glandular hypoesthesia, anesthesia, or altered sensation or pain in the glans related to the suture and only two reported recurrence of a lateral herniation that did not require further treatment. Clinical Implications Distal fixation of the penile prosthesis is a useful surgical adjunct to treating patients with prosthetic lateral extrusions or crossovers that can be applied in almost all cases. Strengths and Limitations Considering these rare complications, our experience is based on a relatively large number of patients and showed a low incidence of complications and a high satisfaction rate. The main limitation of this study is the retrospective nature of the data and the series included patients from two high-volume surgeons that might not be generalizable to all practices. Conclusion The distal corporal anchoring stitch is safe and effective in securing distal fixation of the extruding inflatable penile prosthesis. Antonini G, Busetto GM, Del Giudice F, et al. Distal Corporal Anchoring Stitch: A Technique to Address Distal Corporal Crossovers and Impending Lateral Extrusions of a Penile Prosthesis. J Sex Med 2017;14:767–773.",
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T2 - A Technique to Address Distal Corporal Crossovers and Impending Lateral Extrusions of a Penile Prosthesis

AU - Antonini, Gabriele

AU - Busetto, Gian Maria

AU - Del Giudice, Francesco

AU - Ferro, Matteo

AU - Chung, Benjamin I.

AU - Conti, Simon L.

AU - Suarez Sarmiento, Alfredo

AU - Pacchiarotti, Arianna

AU - De Berardinis, Ettore

AU - Perito, Paul E.

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N2 - Background Unidentified distal crossovers, delayed distal crossovers, and impending lateral extrusion are complications of penile prosthesis implant insertion but are not as common as prosthesis infection or mechanical failure. Aim To evaluate results of a surgical technique, the distal corporal anchoring stitch, that addresses fixation of the penile prosthesis in patients with these complications. Methods A lateral sub-coronal incision is used on the side where the crossover or laterally extruding cylinder should be positioned. Dissection is carried through the Buck fascia, followed by a transverse incision of the tunica albuginea, where the distal aspect of the affected cylinder is delivered. A 4-0 PDS suture is threaded through the distal cylinder ring of the implant. A new, properly positioned intracorporal channel is created and the suture is passed through the distal end of the channel. Once the suture is through the glans and the cylinder is in the correct position, a small cruciate incision is made on the glans at the location of the anchor stitch. The suture is tied with the knot buried in the glans tissue. Outcomes Fifty-three patients underwent treatment of their distal penile implant crossover with a distal corporoplasty using this method and their anatomic and functional outcomes and overall satisfaction were evaluated. Results This technique ensured that the cylinder remained in the newly created, appropriately positioned channel. No patients developed infections, wound-healing defect, glandular hypoesthesia, anesthesia, or altered sensation or pain in the glans related to the suture and only two reported recurrence of a lateral herniation that did not require further treatment. Clinical Implications Distal fixation of the penile prosthesis is a useful surgical adjunct to treating patients with prosthetic lateral extrusions or crossovers that can be applied in almost all cases. Strengths and Limitations Considering these rare complications, our experience is based on a relatively large number of patients and showed a low incidence of complications and a high satisfaction rate. The main limitation of this study is the retrospective nature of the data and the series included patients from two high-volume surgeons that might not be generalizable to all practices. Conclusion The distal corporal anchoring stitch is safe and effective in securing distal fixation of the extruding inflatable penile prosthesis. Antonini G, Busetto GM, Del Giudice F, et al. Distal Corporal Anchoring Stitch: A Technique to Address Distal Corporal Crossovers and Impending Lateral Extrusions of a Penile Prosthesis. J Sex Med 2017;14:767–773.

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