Cylinder insertion into scarred corporal bodies: prosthetic urology's most difficult challenge: some suggestions for making the surgery easier.

Corporal fibrosis is a process that involves excessive deposition of scar tissue in response to infection, trauma, or ischemia. It does not occur merely as a result of previous IPP surgery. Excessive development of corporal fibrosis is certain after extraneous and disastrous events such as priapism or the removal of a device for infection. The usual surgical planes and spaces are obliterated by proliferation of scar both in the tissues overlying the corpora and the space within the corpora previously occupied by erectile tissue. To maximize success, specialized instruments, downsized cylinders, and lots of experience are necessities. Prosthetic urology produces, for the most part, happy patients. Fibrosis guys, to a man are not happy. Let the expert have the unhappy patient!