Implantation of penile prosthesis (3-piece inflatable) for erectile dysfucntion in a patient with left orchiectomy for left undescended testis: A cosmetic approach

Erectile dysfunction (ED) results from various functional and organic causes. Its management has always been a challenge to urologists and other physicians. After failing to respond to medical and intracorporal injections, patients might resort to surgical penile prosthesis implants to improve their sexual performance. Apart from functional outcome, cosmetic results also concern such patients. Cosmetic is also affected in patients with undescended testis or those who underwent an orchiectomy. We discuss the case of a diabetic 59-year-old gentleman with a left undescended testis who was receiving medical treatment for longstanding ED with unsatisfactory results of recent. The patient was counseled appropriately and his medical conditions were optimized prior to any possible surgical intervention. A planned laparoscopic orchiectomy was followed 5 months later by implantation of a 3-piece penile prosthesis device, with successfully placing the pump in a fashioned dartos pouch in the empty left hemiscrotum, attaining both satisfactory functional and cosmetic results for the patient. The prosthesis and the implantation of the pump in the empty left hemiscrotum helped the patient attain satisfactory sexual function and a cosmetic and textural resemblance of a full left hemiscrotum the likes of having a normal left testis. This approach boosted his self-confidence about his sexual performance and image, as reported by the patient after years of erectile dysfunction and having an undescended left testicle. Attention should be paid when planning and executing any surgery that will impact a patient's sexual function. Allowing for surgical innovation and studying the current setting could result in great results beyond the presenting complaint. The ability to restore a male patient's sexual function with implantable prosthesis along with good cosmetic results of the penis and the hemiscrotums can enhance the patient's final experience and level of satisfaction.