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Montague DK, Angermeier KW. Corporeal Excavation: New Technique for Penile Prosthesis Implantation in Men with Severe Corporeal Fibrosis. Urology 2006;67:1072-1075.

This article is a useful read for the challenging cases where the implanting penile prosthetic surgeon encounters severe corporeal fibrosis. Such cases are encountered in men who have had priapism or removal of an infected penile prosthesis. The authors describe in detail a new technique in this area based on case-notes study and telephonic interviews of 9 patients (4 priapism, 4 removal of infected prosthesis, 1 diabetes). All 9 men had a successful outcome following implanation of 7 AMS 700 CXM (small- diameter) and 2 AMS 700CX (large-diameter).

The incision described is a transverse peno-scrotal incision that is extended in an inverted T fashion to the frenulum. This is well-illustrated by means of 8 colour pictures accompanying the text. The subsequent steps are described briefly but adequately. The important step is the utilisation of the plane between the undersurface of the tunica albuginea and the fibrotic tissue core.