A rare complication of a malleable penile prosthesis: migration to the thigh region

Abstract

A 47-year-old male patient was admitted to our clinic after the sudden loss of penile rigidity 6 months earlier and because of pain radiating from his right groin to the rectal region and the beginnings of tenesmus. He had undergone the implantation of a penile prosthesis only onto his right corpus cavernosum secondary to a penile fracture. The patient had no comorbid diseases, and his physical examination and blood work were normal. Skin erosion secondary to the pressure from the prosthesis was present inferior to the femoral triangle and medial to the anterior thigh in the right groin region, and a hard object was palpated. The other edge of the prosthesis was angled towards the rectal region. After X-rays had been taken, a 14–15 cm-length radioopaque material was detected to have one edge pointed towards the right femoral corpus and the other, towards the rectum (Figure 1). A tubular operation material with a thickness of 1 cm started from the area lateral to the anal canal under the skin and followed a path through a long segment ending at the medial thigh region, according to superficial tissue ultrasonography. His urine culture was sterile, and his laboratory tests were normal. No fistula formations were found. The migrated prosthesis was removed under spinal anaesthesia with the help of a clamp and a dissector via an incision in the region of the medial thigh. The location of the prosthesis was irrigated with a dilute povidone iodine and gentamicin solution after the extraction of the prosthesis. No complications were observed perioperatively. The patient was discharged on postoperative day 1 with oral antibiotherapy. He had no complications at the first week, first month or third month follow-ups after the operation.