John J. Mulcahy, MD, presented “Dilating Scarred Corporal Bodies for Penile Implant Cylinder Placement” for the Grand Rounds in Urology audience in September 2020.
How to cite: Mulcahy, John J. “Dilating Scarred Corporal Bodies for Penile Implant Cylinder Placement” September 2020. Accessed Nov 2024. https://grandroundsinurology.com/dilating-scarred-corporal-bodies-for-penile-implant-cylinder-placement/
Summary:
John J. Mulcahy, MD, Clinical Professor of Urology at the University of Alabama and the University of Arizona, discusses how urologic surgeons should place penile implant cylinders into scarred corpora cavernosa. He explains that the approach taken (either penoscrotal or infrapubic) should be the one with the fewest prior procedures, but notes that many urologists tend to favor one approach over the other. Dr. Mulcahy then discusses the surgical process he follows, from obtaining adequate exposure with a broad incision to selecting an appropriate corporotomy site. He also discusses the tools he finds most useful, including the Otis urethrotome for cutting corporal scar tissue.
Following the presentation, E. David Crawford, MD, Editor-in-Chief of Grand Rounds in Urology and Professor of Urology at the University of California, San Diego, conducts a Q&A session with Dr. Mulcahy. They discuss salvage protocols for prosthetic infections, as well as the role of new evaluation tools, such as next-generation sequencing, for identifying microbes and fungi.
ABOUT THE AUTHOR
After completing graduate studies with a PhD in Physiology at the University of Michigan and a residency in Urology at the Mayo Clinic, Dr. John Mulcahy began his career at the University of Kentucky, where he was Director of Urology at the Cardinal Hill Rehabilitation Hospital. Here he instituted a program of intermittent catheterization in the spina bifida population and sacral rhizotomy in select spinal cord injury patients to achieve conservative bladder dysfunction management. In 1978, he moved to Indiana University Medical Center where he was a Professor of Urology and Chief of Urology at Wishard Memorial Hospital, the county hospital for Indianapolis, for 20 years. His main areas of interest have been urinary incontinence and erectile dysfunction and he has pioneered many treatments and surgical procedures in these areas, including the double cuff artificial urinary sphincter, the windsock technique for repairing proximal crural perforations during penile implant placement, the distal corporoplasty for repairing extruded penile implant cylinders, and the salvage procedure for managing penile implant and artificial urinary sphincter infections. The salvage protocol which he developed has revolutionized the management of prosthetic infections and is used throughout the world. Dr. Mulcahy has received many recognitions, including the Cristol Award from the Mayo Urologic Alumni Association and the Brantley Scott Award from the Bladder Health Council of the American Foundation for Urologic Diseases for Significant Contributions to Urology. The senior class at Indiana University Medical School has chosen him as the Outstanding Professor in the Clinical Sciences. In 2016, Dr. Mulcahy was selected as an Honorary Member of the American Urological Association for outstanding contributions to urology. In 2017, he was presented with the Gold Cane Award by the American Urological Association for outstanding dedication as an academic leader, a mentor training multiple generations of urologists, and an outstanding innovator in urologic prosthetic therapy. In 2019, he received the Living Legends Award from the Society of Urologic Prosthetic Surgeons. For 25 consecutive years, he conducted a course at the AUA Annual Meeting on preventing and managing penile implant complications. He is Past-President of the Sexual Medicine Society of North America (SMSNA) and Past-President of the Society of Urologic Prosthetic Surgeons (SUPS). He was Chairman of the Coalition for the Advancement of Prosthetic Urology (CAPU) and lobbies strongly for insurance coverage for penile implant placement. He has over 100 publications and has edited 5 urology textbooks. He has been a Visiting Professor at numerous academic institutions in this country and throughout the world. He has served on the editorial boards of Urology Times, The International Journal of Impotence Research, and Contemporary Urology, and has also been a reviewer for The Journal of Urology, Urology, the British Journal of Urology, the Journal of Sexual Medicine, and Sexual Medicine Reviews. He is currently Emeritus Professor of Urology at Indiana University and Clinical Professor of Urology at both the University of Arizona and the University of Alabama. He continues to teach urology residents prosthetic implantation and repair techniques and frequently gives grand rounds presentations on topics related to erectile dysfunction and male urinary incontinence.
