Synchronous management of urethral stricture disease and penile prosthesis implantation: a case series

There is currently limited data to describe managing a urethral stricture identified while attempting penile prosthesis placement. This study reports our management of urethral strictures during penile prosthesis placement and proposes a guideline for this event. A retrospective analysis was performed on patients who underwent penile prosthesis implantation and had incidentally found urethral stricture disease from 2009 to 2023. Cases that proceeded to the placement of penile implant were classified as "completed," while cases that could not proceed were classified as "aborted." Successful management was defined as the absence of complications requiring explantation within 90 days of the procedure. Twenty-four cases were identified. Of these twenty-four patients, eighteen had completed procedures, while six had their procedures aborted. Within 90 days after the procedure, one patient presented with urinary retention. No patients had penile prosthesis infections within 90 days. Of the six "aborted" patients, five had strictures greater than 2 cm in length with urethral lumens between 8-10F. One patient had an obliterated urethra; three patients underwent urethroplasty; one patient underwent urethral dilation and suprapubic tube placement; and two patients underwent a direct vision internal urethrotomy. This retrospective study surrounding synchronous penile prosthesis implantation and urethral stricture disease management yielded high success and low complication rates.