Suprapubic Cystostomy for the Management of Urethral Injuries During Penile Prosthesis Implantation

Bibliographic Details
Title: Suprapubic Cystostomy for the Management of Urethral Injuries During Penile Prosthesis Implantation
Authors: Uzoma A. Anele, MD, Brian V. Le, MD, Arthur L. Burnett, MD, MBA
Source: Sexual Medicine, Vol 2, Iss 4, Pp 178-181 (2014)
Publisher Information: Oxford University Press, 2014.
Publication Year: 2014
Collection: LCC:Medicine
Subject Terms: Penile Reconstruction, Penile Fibrosis, Corporal Dilation, Erectile Dysfunction, SPT, Medicine
More Details: Introduction: Urethral injury is an uncommon surgical complication of penile prosthesis (PP) surgery. Conventional dogma requires abortion of the procedure if the adjacent corporal body is involved or delayed implantation to avert device infection associated with urinary extravasation. Besides the setback of the aborted surgery, this management approach also presents the possible difficulty of encountering corporal fibrosis at the time of reoperation. Aim: We report an approach using primary urethral repair and temporary suprapubic cystostomy for the management of incidental urethral injuries in a cohort of patients allowing for successful completion of unaborted PP implantation. Materials and Methods: We performed a retrospective analysis of all patients receiving PPs from 1990 to 2014 in which incidental urethral injuries were repaired and PP implantation was completed with suprapubic cystostomy (suprapubic tube [SPT] insertion). After allowing for urethral healing and urinary diversion via SPT for 4–8 weeks, the PP was activated. Main Outcome Measures: Successful management was determined by the absence of perioperative complications within 6 months of implantation. Results: We identified four cases, all receiving inflatable PPs, managed with temporary suprapubic cystostomy. These patients sustained urethral injuries during corporal dissection (one patient), corporal dilation (one patient), and penile straightening (two patients). All patients were managed safely and successfully. Conclusion: Primary urethral repair followed by temporary suprapubic cystostomy offers a surgical approach to complete PP implantation successfully in patients who sustain urethral injury complications, particularly for complex PP surgeries. Anele UA, Le BV, and Burnett AL. Suprapubic cystostomy for the management of urethral injuries during penile prosthesis implantation. Sex Med 2014;2:178–181.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2050-1161
Relation: http://www.sciencedirect.com/science/article/pii/S2050116115300015; https://doaj.org/toc/2050-1161
DOI: 10.1002/sm2.44
Access URL: https://doaj.org/article/adcfabc2fe104dc2bbabc966e25fcb2c
Accession Number: edsdoj.fabc2fe104dc2bbabc966e25fcb2c
Database: Directory of Open Access Journals
More Details
ISSN:20501161
DOI:10.1002/sm2.44
Published in:Sexual Medicine
Language:English