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Penile intracavernosal pillars: lessons from anatomy and potential implications for penile prosthesis placement

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Abstract

The objective of this study was to anatomically describe the relationship of penile intracavernosal pillars to penile surgery, specifically corporal dilation during penile prosthesis placement. Corpora cavernosa from four embalmed male cadavers were dissected and subjected to probe dilation. Corpora were cross-sectioned and examined for the gross presence and location of pillars and dilated spaces. Infrapubic penile prosthesis insertion was performed on one fresh-frozen cadaveric male pelvis, followed by cross-sectioning. A single patient had intracavernosal pillars examined intraoperatively during Peyronie’s plaque excision and penile prosthesis insertion. Intracavernosal pillars were identified in all cadavers and one surgical patient, passing obliquely from the dorsolateral tunica albuginea across the sinusoidal space to the ventral intercorporal septum. This delineated each corpus into two potential compartments for dilation: dorsomedial and ventrolateral. Dorsal dilation seated instruments and prosthetics satisfactorily in the dorsal mid glans and provided additional tissue coverage over weak ventral areas of the tunica albuginea, while ventrolateral dilation appeared to result in ventral seating and susceptibility to perforation. Intracavernosal pillars are an important anatomic consideration during penile prosthesis placement. Dorsal dilation appears to result in improved distal seating of cylinder tips, which may be protective against tip malposition, perforation or subsequent erosion.

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Acknowledgements

We would like to thank our illustrator, Vanessa Dudley, for significant contributions to this work. No research support or funding was received in connection with this study.

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Correspondence to M J Pagano.

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No research support or funding was received in connection with this study. Drs Pagano, Weinberg, Deibert, Alukal, Zhao, Egydio and Mr Hernandez have no conflict of interest. Dr Wilson reports consultation fees and non-financial support from Abreon, Boston Scientific Corp., Coloplast Corp., Neotract and Sontec Instruments outside of the submitted work. Dr Valenzuela reports consultation fees and non-financial support from Boston Scientific Corp., Coloplast Corp. and Neotract outside of the submitted work.

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Pagano, M., Weinberg, A., Deibert, C. et al. Penile intracavernosal pillars: lessons from anatomy and potential implications for penile prosthesis placement. Int J Impot Res 28, 114–119 (2016). https://doi.org/10.1038/ijir.2016.12

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  • DOI: https://doi.org/10.1038/ijir.2016.12

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