Research and Reports in Urology (Feb 2023)
A Unique Case of Inflatable Penile Prosthesis (IPP) Implantation and Mesh Phalloplasty in a Patient Born with Congenital Fusiform Megalourethra
Abstract
Alfredo Berrettini,1 Irene Paraboschi,1 Massimo Di Grazia,1 Michele Gnech,1 Guglielmo Mantica,2 Dario Guido Minoli,1 Erika Adalgisa De Marco,1 Gianantonio Manzoni,1 Marco Capece,3 Alessandro Palmieri,3 David Ralph,3 Vincenzo Mirone3 1Department of Pediatric Urology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milano, Italy; 2Department of Urology, IRCCS Ospedale Policlinico San Martino, Genova, Italy; 3Department of Urology, Azienda Ospedaliera Universitaria “Federico II”, Napoli, ItalyCorrespondence: Irene Paraboschi, Department of Pediatric Urology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, Milano, Italy, Tel +393313229495, Email [email protected]: We present the first case of a patient born with congenital fusiform megalourethra who underwent the successful placement of an inflatable penile prosthesis (IPP) and mesh phalloplasty due to primary erectile dysfunction (ED). After an extensive psychosexual assessment and a preoperative MRI scan, an IPP was successfully implanted. The procedure was carried out through a penoscrotal approach, which offered excellent exposure to the crura and the proximal ends of the corpora cavernosa. Following the incision and the dilatation of both corpora cavernosa, the penile cylinders were inserted and a mesh phalloplasty was performed, to replace the erectile tissues lacking in the distal corpora cavernosa. After reservoir and pump placement, the device was tested, and no mechanical issues were recorded. The postoperative course was uneventful, and, at the 2-year follow-up, the patient reported highly satisfactory results, with valid functional erections.Keywords: congenital fusiform megalourethra, inflatable penile prosthesis, phalloplasty, erectile dysfunction
