This capability makes MR imaging particularly helpful in determining the need for surgical intervention, which is largely based on the integrity of the tunica albuginea. Moreover, because the tunica albuginea is well demonstrated as a low-signal-intensity structure on both T1- and T2-weighted images, MR imaging is optimal for the evaluation of the integrity of this anatomic structure even in patients with severe pain and swelling of the penis. MR imaging can accurately depict the presence, location, and extent of tunical tear, which manifests as discontinuity of the tunica albuginea. Because of its multiplanar capability and excellent tissue contrast, magnetic resonance (MR) imaging can be a useful diagnostic tool in the evaluation of patients with acute penile fracture. The silicone base that covers the cylinders is visible as a T2 hypointense layer outlining their shape 3.Penile fracture is a rare but serious urologic condition that typically requires surgical repair. IPPs appear T2 hyperintense due to their volume of saline solution. This is significant as fractures can occur along the shaft 3. Some models may have articulated sigments that may be indentified by heterogenous signal intensity 3. MPPs appear hypointense on T1 and T2 imaging due to low signal intensity of the metalic core and it's silicone cover 3. The penis itself can also be taped to the anterior abdominal wall. When positioning the patient, they should be placed in the supine position with a towel placed between the legs to ensure elevation of the penis and scrotum 3. MRI is the modality of choice for investigation of patients with suspected penile prosthesis complciations 3. Infections, fractures and hematomas can be assessed emergently however due more widespread access to CT imaging 3. While both MPPs and IPPs are visible on CT, internal archetcture is not easily visible and position within the corpora cavernoa cannot be confidently assessed 3. UltrasoundĬomplications such as resevour migration, blockage and leakage of IPP implants can be diagnosed on ultrasound imaging 3. Historically IPPs were filled with radiopaque material allowing visualization on plain film but this is no longer the case as saline solution is used 2. Plain films are only capable of identifying complications of a mechanical nature such as fractures and torsions of MPPs due to their metalic core.Īs IPPs have become more mainstream and their only metalic component is the rear tip extender at the base, plain film has become an outdated imaging modality 3. More popular as offers the best flaccidity with rigidity nearing that of a natural erection, placement however is surgically complex 2 Primarily non-metallic (unlike MPPs) excluding a rear tip extender component at the base that guarantees stability 3 Three-piece: consists of two cylinders within the corpora cavernosa, a pump in the scrotum with a reservoir placed adjacent to the bladder 2 Two-piece: consists of two cylinders within the corpora cavernosa and a resipump (combined pump and reservoir) placed in the scrotum 2 Hydraulic or inflatable penile prostheses (IPP) More prone to lateral perforation and distal erosion 2 Usually made of stainless teal or a braided silver core coated in silicone 2 Paired malleable rods that are inserted surgically into each corpora cavernosa 2 Semirigid or malleable penile prostheses (MPP)
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