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.