Floppy Glans Syndrome: Pathogenesis and Treatment

Area of Science:

• Urology
• Andrology
• Surgical Complications

Background:

• Floppy glans syndrome (FGS) is a potential complication following penile prosthesis implantation for erectile dysfunction.
• FGS can lead to glans droop (ventral, dorsal, or lateral), causing pain and sexual dissatisfaction.
• Severe cases may result in flail penis or S-shaped deformity due to incorrect cylinder sizing.

Purpose of the Study:

• To review the types, causes, and management strategies for Floppy glans syndrome (FGS).
• To clarify nomenclature for related conditions like flail penis and supersonic transporter deformity.
• To provide guidance on defining, diagnosing, and treating FGS.

Main Methods:

• Comprehensive literature search.
• Analysis of clinical experience in managing FGS at the authors' institution.

Main Results:

• FGS often stems from poor intraoperative prosthetic cylinder positioning or sizing, leading to inadequate venous compression.
• Insufficient glanular blood flow and poor structural support can also contribute to FGS, even with correct implant placement.
• Treatment options include medical management, distal penoplasty, and glanulopexy, which are effective in correcting the deformity.

Conclusions:

• Floppy glans syndrome (FGS) is a complex condition with varied presentations.
• Accurate diagnosis is crucial for selecting the most appropriate treatment pathway.
• Surgical interventions like distal penoplasty and glanulopexy offer effective solutions for FGS.