The cavernotomes were used in nineteen patients with corporeal fibrosis. The etiology of the fibrosis was removal of previously infected prosthesis (15), extensive fibrosis from recurrent priapism secondary to sickle cell disease (2), pharmacologic injection program and subsequent Winter shunts (2). One of the patients whose prosthesis was removed for infection also had a tip erosion on the contralateral side necessitating the creation of a subcapsular space for the insertion of a new cylinder.
After a small corporotomy is created, the cavernotomes are introduced and moved in an oscillating motion resulting in forward advancement. If more resection is needed, rotation of the cavernotomes will create a “shaving” action which removes 1 mm strips of fibrotic tissue.
- Cutting can be done both in a longitudinal, up and down, movement, or in a “drilling” rotational movement.
- The largest size (13 mm) corresponds to standard cylinder diameter. Dilation to 10 mm is necessary for insertion of the Furlow tool or the Mentor NB cylinder base. Dilation to 11 mm is necessary for the insertion of the AMS CXM base.
- Internal cutting of the fibrosis obviates extensive corporotomies and results in quicker procedures.
- The cavernotome’s design and oscillating advancement promote safe dilation without perforation.