BACKGROUND:

The placement of a penile prosthesis is third-line treatment in patients with erectile dysfunction. One of the most dreaded complications is distal extrusion of the prosthesis, which occurs when the tunica albuginea becomes weakened.

CLINICAL CASE:

A 65-year-old man had a history of 2-piece penile prosthesis placement. Eight years later the prosthesis exhibited mechanical malfunction and was replaced with a 3-piece prosthesis. The patient’s present illness began with pain in the right distal-lateral region of the body of the penis. Magnetic resonance imaging confirmed prosthesis extrusion, with no perforation of the tunica albuginea. Surgical procedure with the Mulcahy technique and replacement of the entire prosthesis was decided upon. The procedure was performed with distal corporotomy and a transversal capsular incision of the corpus in the dorsal position, as well as a new dilation in the distal portion. The prosthesis was placed in the new cavity (pseudocapsule). Six weeks after the surgery the penile prosthesis was activated, with satisfactory functional progression and no pain for the patient. Control magnetic resonance imaging showed adequate position of the prosthesis.

CONCLUSION:

The Mulcahy technique is an effective option with a high success rate and low infection rate in patients with prosthesis extrusion in the lateral part of the penis.

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