Mesh in Penile Prosthesis Surgery: Friend or Foe?

M. Muní i Sureda, C. Casanova, M. D'anna, D. Corominas, X. Bonet, J M Corral, A. Medina, I. Martínez, P. Lluís, J. Torremadé

Peyronie’s disease, Penile prosthesis, Revision surgery, Mesh, Magnetic Resonance Imaging

This case report describes a 64-year-old man with Peyronie’s disease and multiple prior surgeries, illustrating the challenges of penile prosthesis implantation after grafting and mesh use. Following initial corporoplasty with porcine dermal graft and subsequent malleable prosthesis placements complicated by cylinder migration, urethral extrusion, and urethral injury, preoperative MRI revealed fibrosis and unidentified intracavernosal material. Revision surgery identified residual mesh from earlier procedures, causing severe fibrosis and technical difficulty during dilation and cylinder placement. After careful dissection, rerouting, and bilateral cavernotomies, a three-component inflatable penile prosthesis was successfully implanted with good postoperative outcomes. The case highlights that while mesh can provide tunical reinforcement, it may hinder future revisions due to fibrosis and scarring. Meticulous surgical planning and technique are essential in complex, multi-operated Peyronie’s disease patients requiring penile prosthesis implantation.

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