The case of the month

March 2006 case

The first part of the procedure consisted in a resection of the fibrosis secondary to the necrosis of the distal part of the corpora cavernosa and corpus spongiosum. The dorsal pedicle was preserved attached to the remaining part of the glans (Figure 1).

The second part of the procedure was the section of the suspensory ligament of the penis using a “V to Y” incision and the whole dissection of the penile shaft from the penile foreskin (Figure 2).

A PTFE piece was then suture in place of the suspensory ligament to avoid retractile fibrosis. The penile foreskin was readjusted on the penile shaft, and the prepubic skin was closed in “Y” (Figure 3).

The final part of the procedure used the dorsal cutaneous flap and the remaining glans to recreate a urethral meatus and a sensitive and erectile “glans like” penile distal part.

The foley catheter was left in place 10 days (Figure 4).

The patient recovered spontaneous erection and sensitivity of the “glans”. He obtained an authorization to stay in France to be treated and followed. Until now he never had sexual relationship.

Final result 2 month after surgery (Figures 5 and 6).