What is it about?
This article describes a challenging case involving a man with a penile implant who developed a shrinking, soft glans (the tip of the penis). Over time, the glans became too weak to support the implant, putting him at risk of prosthesis extrusion—a serious complication where the implant begins to push through the skin. The patient had undergone multiple previous implant surgeries, and each revision made the anatomy more fragile. When he arrived for treatment, the glans was soft, small, and unstable, and the implant was shifting forward. The authors use this case to highlight several key points: A soft or shrinking glans is more common than many surgeons realize. Early warning signs are often missed due to limited understanding of glans anatomy. Proper implant positioning and glans‑supporting techniques are essential to prevent extrusion. With the right surgical approach, even difficult cases can be successfully salvaged. In short, the article raises awareness about a preventable complication and emphasizes the importance of anatomy‑guided surgical technique in penile implant surgery.
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Why is it important?
1. It highlights a preventable complication A shrinking, soft glans is more common in penile implant patients than many people realize. If it’s not recognized early, it can lead to prosthesis extrusion, a serious complication. This case shows that early detection and proper technique can prevent failure. 2. It shows the consequences of repeated surgeries The patient had undergone multiple implant revisions. Each revision made the anatomy more fragile, increasing the risk of complications. The report reminds surgeons to be especially careful in complex, multi‑revision cases. 3. It emphasizes the importance of anatomy Many complications happen because surgeons underestimate the detailed anatomy of the glans. This case demonstrates that understanding fibro‑vascular structures is essential for: stable implant positioning preventing forward migration avoiding extrusion 4. It encourages better surgical practice The authors point out that recommendations to prevent extrusion have existed for decades, yet many surgeons still overlook them. This case reinforces the need for updated, anatomy‑guided surgical techniques. 5. It provides a learning opportunity for the field By documenting this case, the authors help other clinicians recognize early warning signs and avoid repeating the same mistakes. It contributes to better patient outcomes and stronger long‑term implant success.
Perspectives
1. Clinical Perspective This case reminds clinicians that a shrinking, soft glans is not a minor issue—it’s an early warning sign of possible implant failure. Recognizing these changes early can prevent serious complications like extrusion. 2. Surgical Perspective The report highlights how precise anatomical understanding is essential in penile implant surgery. Even small errors in cylinder positioning can lead to long‑term problems. This case reinforces the need for careful technique, especially in revision surgeries. 3. Patient Perspective For patients, this case shows that complications such as glans softening or implant shifting are treatable when addressed early. It also emphasizes the importance of choosing surgeons who understand the detailed anatomy involved in implant placement. 4. Educational Perspective This case serves as a teaching example for trainees and surgeons. It demonstrates: how complications develop what early signs to look for how proper technique can prevent implant failure It reinforces the value of anatomy‑guided surgical planning. 5. Research Perspective The case highlights a gap between what is known and what is practiced. Despite decades of recommendations, some surgeons still overlook key anatomical principles. This report encourages further research and better surgical education to reduce preventable complications.
Dr. Geng Long Hsu
Read the Original
This page is a summary of: Coil Embolization Is Not Justified for Treating Patients with Veno-Occlusive Dysfunction: Case Series and Narrative Literature Review, Life, July 2024, MDPI AG,
DOI: 10.3390/life14070911.
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