Complex reimplantation of an inflatable penile prosthesis with scar tissue excision and distal corporal defect repair with Tutoplast® pericardium allograft

Background: Patients with inflatable penile prostheses (IPP) may experience erosions after years of use or after indwelling Foley catheter placement. IPP erosions should be managed as an infection with the entire IPP removed. Replacing IPPs in erosion patients can be challenging due to extensive scarring development. Using proper graft materials may be necessary to close and reinforce the corporal defect after difficult corporal dilation or significant scar removal for the long-term success of IPP reimplantation. Case Presentation: Herein we report a patient with a history of IPP placement in 2007 for erectile dysfunction and Peyronie's disease, presenting in 2018 with dysuria and a feeling of IPP displacement following Foley catheter placement for coronary artery bypass graft surgery. The left cylinder of the IPP was observed by physical examination and a defect near the fossa navicularis was discovered during office cystoscopy. A complete explantation of IPP was then performed. Reimplantation of the IPP was performed in 2021 which required excision of corporal scar tissue and repair of a left distal corporal defect using a Tutoplast® pericardium allograft. The procedure was successful with proper IPP position and good function without any penile deformity. Conclusion: The use of graft materials in the management of corporeal defects should be considered in the setting of complex IPP revision. The Tutoplast® pericardium allograft reinforcement can provide long-term durability, flexibility, and a lower risk of infection.