Rigi10™ Malleable Penile Prosthesis
Also Known As
Floppy glans syndrome, floppy glans phenomenon, real glans hypermobility, glanular hypermobility, SST deformity (supersonic transport appearance)
Definition
Glans hypermobility is a condition where the glans penis droops or moves excessively after penile prosthesis implantation.1 This phenomenon presents as a rarely observed complication that may result in patient dissatisfaction due to painful intercourse, difficulties during penetrative sex, and poor cosmetic results.2 The condition can prevent patients from using an otherwise fully functional implant.2 Glans hypermobility can result from soft glans tissue, incorrect position or size of the implant cylinders, or the anatomy of the glans itself.3 A careful physical examination with a fully inflated implant will indicate the direction of the droop and can help distinguish the underlying cause of the deformity.2
Clinical Context
Glans hypermobility is clinically observed following penile prosthesis implantation, a surgical procedure used to treat erectile dysfunction (ED) in patients who are unresponsive to other forms of treatment.4 The condition is diagnosed through careful physical examination with a fully inflated implant, which reveals the direction and severity of the glans droop.2 In ambiguous cases, obtaining a correct diagnosis may involve imaging techniques such as magnetic resonance imaging (MRI) or penile ultrasound scanning of the inflated device.2
The etiology of glans hypermobility is multifactorial and can be categorized based on the underlying cause. It may result from soft glans tissue, incorrect position or size of the implant cylinders, or anatomical variations of the glans itself.3 Hypermobile glans deformity has been considered a “complication” of penile prosthesis implantation in which the glans penis does not mount properly on the anterior tip of the inflated cylinders.3
Management options include both medical therapy and surgical intervention. Medical therapy can be attempted before revision surgery, as long as it is safe for the patient and does not compromise the function of the implant.2 Surgical correction typically involves a glanspexy procedure, which should be performed according to the surgeon’s experience and preference.2 Before any treatment is provided, the accuracy of the position and size of the implant should be thoroughly assessed to confirm the diagnosis of real glans hypermobility.2