A New Access for Implantation of a Malleable Penile Prosthesis During Perineal Radical Prostatectomy

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ABSTRACT

The present 67-year-old male had clinically localized prostate cancer and needed a perineal radical prostatectomy. He also needed prosthesis implantation for severe erectile dysfunction. We describe a new perineal access for implantation of a malleable penile prosthesis during the prostatectomy surgery that does not require a second incision. The prostatectomy technique was not altered. Prosthesis implantation began after removal of the prostate and before performing the vesicourethral anastomosis. The procedure is described. Dilatation of the cavernous bodies and prosthesis implantation were performed without technical problems. Transoperative bleeding was similar to that observed for prosthesis implantation through a penile access. No shortening of the urethral stump was observed and vesicourethral anastomosis was performed without difficulty. Surgical time was 40 minutes. Use of the same access for the 2 procedures is easy and has low morbidity. This approach should be considered by other surgeons for patients with prostate cancer and severe erectile dysfunction.

Mario Paranhos, Enrico Andrade, Luiz Carlos Neves de Oliveira, Marcos Dall`Oglio, Alberto Antunes, Joaquim A Claro, Miguel Srougi

Division of Urology, University of São Paulo Medical School, São Paulo, Brazil

Submitted September 10, 2010 - Accepted for Publication October 9, 2010

KEYWORDS: Erectile dysfunction; Penile prosthesis; Prostatic cancer; Radical perineal

CORRESPONDENCE: Dr. Mario Paranhos, Rua Mapuá¡, 16 – Chá¡cara Inglesa, CEP-04647-030, São Paulo, Brazil (marioparanhos@uol.com.br).

CITATION: Urotoday Int J. 2010 Dec;3(6). doi:10.3834/uij.1944-5784.2010.12.05