941Vol. 10    |    No. 3    |    Summer 2013    |U R O LO G Y   J O U R N A L

Urology Department, San Cecilio 
University Hospital, Granada, 
Spain

* E-mail: arrabalp@ono.com

A 39-year-old man with a medical history of hypertension, type I diabetes mellitus (HbA1c: 7%) and 3 components penile prosthesis for erectile dysfunction refrac-tory to medical treatment implanted 9 years before, presented at the Urology 
Department. He reported an extrusion of the prosthesis through the urethral meatus avoid-
ing spontaneous urination (Figure). Three months before during an intense sexual inter-
course (“cowboy sex” syndrome), the patient had pain in the penis and latter the prosthesis 
started to appear through the meatus. The function of the prosthesis had been successful 
during these years. A physical examination showed one cylinder through the meatus with-
out inflammation or infection signs (no pus collection). A longitudinal peno-scrotal incision 
checking the extrusion of left cylinder through the left side of the urethra was performed 
and the cylinder was removed keeping the patient without a bladder catheter. Two months 
after surgery the patient had a normal urination and sexual intercourse with the use of a 
single cylinder of the penile prosthesis.
Penile prosthesis extrusion is a rare complication produced by infection, trauma, intense sex-
ual activity(1) and in relation with diabetes mellitus, radiotherapy or neurological problems. 
(2) Once the extrusion has been produced, treatment depends on the type of perforation. Some 
authors repair the erosion with good results(3) and others prefer to remove the prosthesis.(2)

Miguel Ángel Arrabal-Polo, Fernando López-Carmona Pintado, Samuel González-Torres

Transurethral Extrusion of 
Penile Prosthesis

REFERENCES
1. Salama M, Kishimoto T, Kanayama HO, Kagawa S. Unusual trivial trauma may end with extru-

sion of a well-functioning penile prosthesis: a case report. J Med Case Rep. 2007;1:34.

2. Shaeer O. Management of distal extrusion of penile prosthesis: partial disassembly and tip re-
inforcement by double breasting or grafting. J Sex Med. 2008;5:1257-62.

3. Shindel AW, Brant WO, Mwamukonda K, Bella AJ, Lue TF. Transglanular repair of impending 
penile prosthesis cylinder extrusion. J Sex Med. 2010;72884-90

PICTORIAL  UROLOGY

Figure. Extruded penile 
prosthesis through the 
urethral meatus