人工陰莖成形術後嚴重併發症:
龜頭壞死併恥骨上膿瘍
蔣孟哲 周有偉 姜秉均 廖俊厚
天主教耕莘醫療財團法人耕莘醫院
Severe complication post Penile prosthesis surgery:
Penile glans necrosis with Suprapubic abscess
Meng-Che Chiang, Yu-Wei Chou, Bing-Juin Chiang, Chun-Hou Liao
Cardinal Tien Hospital, New Taipei City, Taiwan
Purpose:
Penile prothesis is an excellent option for well-selected patients, offering high patient satisfaction and a low rate of complications. Most urologists or surgeons who perform the procedure may have limited experience. Complication various, perforation, urethral injury, penile curvature, glans mobility, and hemostasis.
Materials and Methods:
We present a case of a 50 y/o male, with history of type 2 diabetes mellitus, hypertension and morbid obesity (Height: 179cm, Weight:128kg, BMI:39.9) status post sleeve operation. Patient experienced penile prosthesis surgery with penile elongation 10 days prior and complained of swelling and redness over suprapubic area and discoloration of penile glans.
Results:
Foul smell and pus-like discharge from suprapubic wound. Penile glans necrosis with gangrene change. Distal glans erosion and protruding of bilateral semirigid prosthesis from glans. Re-open wound over suprapubic area and open drainage, bilateral prosthesis was removed.
Conclusion:
Penile prosthesis implantation is a fascinating surgical technique that has gained an important role in the treatment of severe erectile dysfunction. Penile elongation can gain patients self-confidence. Complication occurrence maybe due to oversized implants; or underlying poor controlled diabetes. Patients obese stature, oversized abdomen and pubic fat might have increased the pressure over the prostheses causing poor wound healing or regional area avasculation. Open drainage and antibiotic treatment to control infection. Penectomy are mostly unavoidable when glans gangrene change has occurred.