PMC9939796_01
Preoperative MRI scan of the penis and pelvic floor. Sagittal (A) and axial (B and C) images showed severe hypoplasia of the corpus spongiosum and distal deficiency of both corpora cavernosa. The prostate gland was small and almost difficult to identify. These findings were compatible with the diagnosis of the fusiform variety of congenital megalourethra.
RRU-15-85-g0001.jpg
PMC9939796_01_RRU-15-85-g0001.jpg
f0001
Intraoperative images showing the configuration of the inflatable penile prosthesis (IPP). Due to the lack of erectile tissue in the distal corpora cavernosa, an Ultrapro  Macroporous Partially Absorbable Mesh (Ethicon US LLC) shaped as a 6-cm rounded cap was shaped (A) and secured at the tip of the cylinders of the IPP (B and C).
RRU-15-85-g0002.jpg
PMC9939796_01_RRU-15-85-g0002.jpg
f0002
Finally, the penile cylinders were inserted into the penis and the corpora cavernosa were sutured with absorbable stitches (Figure 2). 
Postoperative pictures documenting valid penile erections. Highly satisfactory results were documented at the end of the surgical procedure (A) and at the 2-year follow-up (B and C). A maximally turgid state was achieved by inflating the three-piece IPP using the scrotal pump placed in the right subdartos pouch.
RRU-15-85-g0003.jpg
PMC9939796_01_RRU-15-85-g0003.jpg
f0003
The device was tested to exclude any mechanical damage and was left partially inflated to minimize the formation of postoperative hematomas (Figure 3). 