Management of nondilatable cavernous fibrosis with the use of a downsized inflatable penile prosthesis

The basic underlying cause of inability to implant a penile prosthesis is cavernous fibrosis resulting in unsatisfactory cavernous dilation. During the last 3 years, 20 patients with severe cavernous fibrosis underwent penile prosthetic implantation with a downsized inflatable penile prosthesis, obviating the need for additional cavernous reconstruction. After a mean followup of 20 months 19 of the 20 patients had a functional device with only 1 requiring explantation for infection. We believe that this downsized penile prosthesis is a valuable addition to the urological armamentarium when considering reimplantation or implantation in a patient with intracavernous fibrosis and scarring.