Top ten surgical tricks-penile prosthesis with corporal fibrosis

Penile prosthesis implantation in cases of corporal fibrosis is the ultimate challenge in prosthetic urology. This report describes the top ten tips and tricks based on literature review and the authors' experience for such cases. PubMed search was conducted for the terms "penile prosthesis" and ("scarred" or "scarring" or "fibrosis" or "cavernotome"), up to February 2026 with no start date. Contemporary classic surgical techniques were classified into the more invasive "open techniques" and the less invasive "closed techniques". The authors' preferred techniques are described, as well as the proactive measures against corporal fibrosis. Tips and tricks cover patient counseling, problem-oriented patient evaluation, tips for tailored cylinder selection, optimal use of rear-tip extenders, size enhancement procedures, and advice for post-operative care. In conclusion, there is no consensus on the optimal management of corporal fibrosis during implantation. It is the authors' experience that whenever feasible, closed techniques are preferred to open techniques. The tips -detailed herein- may enhance safety and outcome.