From the Guidelines
A penile extension of 3 cm externally is not a typical presentation of Peyronie's disease or any other condition, and it is crucial to evaluate this finding in the context of the patient's overall health and medical history. The provided evidence does not directly address a penile extension of 3 cm, but it discusses the evaluation and management of Peyronie's disease and erectile dysfunction. According to the AUA guideline on erectile dysfunction 1, a comprehensive evaluation and targeted physical exam should be performed when a man presents with symptoms of ED, including an assessment of penile skin lesions and placement/configuration of the urethral meatus.
The guideline also recommends examining the penis for occult deformities or plaque lesions with the penis held stretched and palpated from the pubic bone to the coronal sulcus 1. However, the presence/absence of a palpable plaque should not be taken as definitive evidence for clinically relevant penile deformity such as Peyronie’s Disease. If Peyronie’s Disease is suspected, then additional diagnostic procedures should be undertaken.
In the context of Peyronie's disease, the AUA guideline 1 discusses various treatment options, including tunical plication surgery, plaque incision or excision and/or grafting, and penile prosthesis surgery. However, these options are considered for patients with penile deformity and erectile dysfunction, not for a penile extension of 3 cm.
Given the lack of direct evidence addressing a penile extension of 3 cm, it is essential to consult a healthcare provider to evaluate this finding and determine the underlying cause, as it may be related to an underlying medical condition or a complication of a previous procedure. The healthcare provider will assess the patient's overall health, perform a physical examination, and order diagnostic tests if necessary to determine the cause of the penile extension.
In the meantime, it is crucial to monitor for any signs of complications, such as pain, swelling, or discharge, and to seek immediate medical attention if any of these symptoms occur. Proper evaluation and management of this condition are necessary to prevent potential complications and improve the patient's quality of life.
From the Research
Pej Extension
- The question of whether a 3cm external extension of a penile prosthesis (Pej) is okay cannot be directly answered by the provided studies, as they primarily focus on infection prevention and management in penile prosthesis surgery 2, 3, 4, 5, 6.
- However, the studies do discuss various aspects of penile prosthesis surgery, including the importance of proper surgical techniques, patient selection, and infection prevention strategies 2, 3.
- It is worth noting that the extension of a penile prosthesis is a surgical procedure that requires careful consideration of the patient's individual needs and anatomy 5.
- While the provided studies do not specifically address the issue of Pej extension, they do highlight the importance of careful surgical planning and technique to minimize the risk of complications, including infection 4, 6.
Infection Prevention and Management
- The studies emphasize the importance of infection prevention and management in penile prosthesis surgery, including the use of antibiotic-coated devices, proper surgical techniques, and patient selection 2, 3, 4, 5, 6.
- The use of vancomycin/gentamicin irrigation has been shown to reduce the risk of infection compared to Betadine irrigation 4.
- The "no-touch" technique and the use of coated devices have also been shown to reduce the risk of infection 3.
- The management of infected penile prostheses is a complex issue, and more research is needed to develop effective guidelines for prevention and treatment 6.