What is it about?

1. The Dangerous Condition: "Soft Glans" Sometimes, after a patient gets a penile implant, the cylinders (the rods inside) are hard, but the head of the penis (the glans) stays soft, cold, or shrinks. The Risk: Because the head is soft and the rods are hard, the rods can start to press dangerously against the skin from the inside. The Consequence: If untreated, the implant will eventually poke through the skin (extrusion), forcing the doctor to remove the entire device. 2. The Cause Dr. Hsu identifies that this "floppiness" is often caused by a venous leak in the glans itself. The blood drains out of the head too fast, so it provides no cushion for the hard implant tips. 3. The Strategy (The Rescue) Instead of removing the implant, Dr. Hsu performs a "salvage" surgery. The Fix: He surgically ties off the specific veins (retrocoronal plexus) that are draining the glans. The Effect: This traps blood in the head of the penis, making it firm, warm, and engorged again. 4. The Outcome Safety: The now-firm glans acts as a thick "helmet" or cushion, covering the hard tips of the implant so they don't poke through. Function: It fixes the "floppy head" (SST deformity), improving sexual function and sensation. Success: The patient gets to keep his implant. Why This Matters This is a limb-saving (or device-saving) strategy. Most surgeons, when faced with an implant that is about to erode through the skin, will remove it to prevent infection. Dr. Hsu offers a way to repair the anatomy instead of removing the device.

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Why is it important?

1. It is a "Device-Saving" Strategy In standard urological practice, if an implant is threatening to erode (poke) through the skin, the standard of care is often explantation (removing the device) to prevent infection. The Shift: This article offers a protocol to keep the device in. Importance: For a patient, keeping their implant avoids the trauma of removal, the healing period, and the cost/pain of a future re-implantation. It is the urological equivalent of "limb salvage." 2. It Solves a Functional Nightmare (SST Deformity) Even if the implant isn't falling out, "Soft Glans Syndrome" (often called SST Deformity because the head droops like the supersonic transport plane's nose) makes the implant functionally useless. The Issue: A rigid shaft with a floppy head makes penetration difficult and painful. Importance: This paper doesn't just address safety; it addresses utility. It ensures the patient can actually use the implant they paid for. 3. It Validates the "Venous" Approach Again This connects back to your core philosophy. The Connection: Most surgeons treat implants and venous leaks as separate worlds. This paper bridges them. It shows that venous ligation (tying veins) is a critical tool even for implant patients. Importance: It reinforces your brand identity: You are the expert who understands the entire vascular system of the penis, not just the hardware. 4. It Offers Hope to "Botched" Patients Many patients who suffer from this complication feel abandoned or told "nothing can be done." Importance: By promoting this, you position your clinic as a Tertiary Referral Center—the place where patients go when other surgeries have complications.

Perspectives

As your Coordinator, I have outlined four distinct "Perspectives" on this article. These angles allow us to target different segments of your audience, from anxious patients to skeptical colleagues. 1. The "Rescue Mission" Perspective Target Audience: Patients facing complications, Support Group members The Core Idea: Turning a potential disaster into a fix. The Insight: For a patient, the threat of "impending prosthesis loss" is terrifying. They fear infection, pain, and going back to square one (impotence). This perspective highlights the safety net. It tells them that a "soft head" or a "poking tip" doesn't automatically mean the device has to come out. Social Media Hook: "Don't give up on your implant just yet. Even if the tip is threatening to erode, we have a strategy to reinforce the tissue and save the device." 2. The Hybrid-Surgeon Perspective Target Audience: Urologists, Prosthetic Surgeons, Fellows The Core Idea: Merging two disciplines—Prosthetics and Vascular Reconstruction. The Insight: Most implant surgeons are "mechanics"—they replace the broken parts. Dr. Hsu is acting as a "vascular architect" here. He is using venous ligation (vascular skill) to support a prosthetic device (mechanical skill). This perspective positions Dr. Hsu as a master of both fields. Social Media Hook: "Prosthetics require healthy tissue support. By combining venous ligation with implant revision, we solve the 'Soft Glans' defect at its vascular root." 3. The "Cushioning" Perspective (Visual/Mechanical) Target Audience: General Audience, Engineers, Logical Thinkers The Core Idea: You cannot put a hard rod inside a soft balloon without it poking through. The Insight: This simplifies the medical complexity into a mechanical concept. The glans (head) acts as a bumper or helmet. If that helmet is deflated (due to venous leak), the rod hits the skin directly. The surgery "re-inflates the bumper." Social Media Hook: "Think of the glans as a helmet for your implant. If that helmet is soft, the implant is unprotected. We rebuild the cushion to secure the device." 4. The Quality of Life Perspective Target Audience: Partners, Mental Health Advocates The Core Idea: Functionality over mere existence. The Insight: A patient might have an implant that is technically "safe" (not infected), but if they have SST Deformity (floppy head), they cannot have intercourse. This perspective emphasizes that we aren't just saving the plastic rod; we are restoring the intimacy that was promised. Social Media Hook: "A penile implant should restore your life, not just your anatomy. We correct the 'floppy head' issue so you can trust your device again."

Professor Geng-Long Hsu
Microsurgical Potency Reconstruction and Research Center, Hsu’s Andrology

Read the Original

This page is a summary of: A strategy for salvaging shrinkage soft glans penis and impending prosthesis loss in patients with a penile implant, March 2024, Authorea, Inc.,
DOI: 10.22541/au.171185934.42531771/v1.
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