Legends
Figure 1. X-ray imaging on penile implant journeys of this
42-year-old truck driver. A. The penis was putting downward; an
Anterior-Posterior pelvic film disclosed an extender of the penile
prosthesis was left in the right corpus cavernosum
(dark arrow in the inserted film,
right bottom), which obscured the clear space between two cylinders, its
medial location implicated why incomplete hinging malleable implant,
resulting from eliciting pain by compression. B. Further film disclosed
the extender (arrow in the inserted film) making a space competition on
his penoscrotal region while the penis was directed upward. C.
After salvaging surgery, an AP view showed no more extender; note the
film comparison with that in A. D. Again, it showed no extender compared
to the film in B. E. In his fourth penile implant with three pieces of
inflatable type, the pump activator was ready to erose the scrotal skin
(inserted left) and the proximal tip of the implant (dark asterisk in
inserted right). F. Similar finding was noted when the penis was filmed
in a lateral position for comparison with that in E.
Figure 2: Photo and imaging evidence with surgery illustration
of anatomy blueprint in this 42-year-old man. A. Photo of the
implementing prosthesis extrusion via urethral meatus (white
arrow). Note patient’s fingers were holding his penis. B. While the
penis was positioned downward, via a 19G scalp needle (curved arrow)
inserted in the left lateral aspect of the glans penis, a glanography
was conducted via contrast medium injection (white cross), then an
Anterior-Posterior pelvic film disclosed a single malleable penile
prosthesis was shown in the right corpus cavernosum (white arrow) and
three nails for treating his traumatic hip joint resulting from a
suicide attempt (hollow arrow). C. Glanography was obtained in a
30-degree right oblique view while the contrast medium was injected.
Note the erection-related venous plexus was distributed on the dorsal
aspect of the corpora cavernosa, and the corpus spongiosum (curved
double arrow). The implant (white arrow) was ready to extrude through
the urethral meatus. D. The anatomy illustration for reinsertion of the
mislocated implant, salvaging the penile implantation, was made
following the novel strategies for glans enhancement. E. In a 30-degree
right oblique view, appropriate implant location and significant glans
enhancement after the penile venous stripping. Note that the
erection-related venous plexus was no longer seen and, meanwhile, the
corpus spongiosum (curved double arrow) was playing a more significant
role of venous drainage route, compared to those in the C. F. As the
penis was downward, in the glanography in injecting (white cross), the
sustainable implant and significant glans enhancement in physiologically
hemodynamic, compared with those in B.