Inflatable penile prosthesis cylinders out of place during implantation.

It is safe to say that the overwhelming majority of cylinders out of place result from surgeon error at the time of implantation. There are some instances where patient comorbidities could increase the difficulty of accurate development of cylinder insertion or space. Most of the time the operator recognizes his instrument out of place and corrects it intraoperatively. Other times the surgeon makes a flawed movement with a sharp instrument piercing some tissue. When the cylinder is placed initially and inflated the wayward position is usually not evident. However, in the postoperative period, the inaccurate position of the cylinder(s) can become readily apparent. The reader will notice this repeatedly stressed in Wilson's Workshop-over 90% of cylinders that are out of position can be diagnosed or prevented if one utilizes the two safety checks outlined below.