Loyola University Medical Center
Penile prosthesis has successfully managed erectile dysfunction in an otherwise treatment-refractory patient population. Several devices exist including malleable and inflatable/hydraulic prostheses. Different types of penile prosthesis can be characterized by various imaging modalities, with attention to common and uncommon complications.
Educational Goals / Teaching Points
This exhibit will describe imaging appearances of the different types of penile prosthesis on various imaging modalities and demonstrate the complications. Complications specific to the individual part of implants will be described. These include”: A) penile cylinder (malpositioning, erosion, perforation, leakage, aneurysmal dilatation, fractures); B) scrotal pump (infection, hematoma, migration); and C) reservoir complications (fluid leakage, rupture, migration, infection). Ultrasound and CT can be useful in visualization of penile prostheses in the acute setting. But MRI is preferred for its soft tissue contrast, ability to determine the cause of device malfunction or complication, and pre-surgical planning.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
This exhibit includes: penile implant (different devices and their parts); imaging modalities used in penile implant evaluation; and a pictorial review of radiograph, ultrasound, CT, PET-CT, and MRI to describe the parts of a penile implant. The exhibit also reviews MRI protocol optimization for targeted penile prosthesis evaluation and discusses etiologies of penile implant failure and juxtapose their imaging appearance.
Various imaging modalities have different roles in evaluation of penile prosthesis. Systematic approach and understanding of various implant components can help structure differential diagnosis. Clinical significance of prosthesis malpositioning, fracture, and leak often results in surgery for revision/ replacement. MRI has superior soft tissue contrast and can be beneficial for both diagnostic and pre-procedural evaluation.