Rigi10™ Malleable Penile Prosthesis
Also Known As
Supersonic Transporter (SST) deformity, Glans hypermobility, Glanular hypermobility, Drooping glans syndrome
Definition
The Concorde Deformity, also known as Supersonic Transporter (SST) deformity, is a complication that can occur following penile prosthesis implantation characterized by ventral or lateral deflection of the glans penis1. This condition presents as excessive mobility or hypermobility of the glans penis in relation to the corporal bodies, creating an appearance similar to the drooping nose of the Concorde aircraft2. The deformity typically results from an undersized penile prosthesis, inadequate distal corporal dilation, or anatomical variants in the distal corpora3. This complication can cause functional difficulties during sexual intercourse and may lead to patient and partner dissatisfaction4.
Clinical Context
The Concorde Deformity occurs in approximately 5% of penile prosthesis implantation procedures1. It is primarily encountered in patients who have undergone penile prosthesis surgery for erectile dysfunction. Risk factors include diabetes mellitus, prior penile surgery, priapism, and androgen deprivation therapy, all of which can contribute to corporal fibrosis and contraction4.
Clinically, patients present with ventral or lateral deflection of the glans penis and excessive glanular mobility despite adequate sizing of the penile prosthesis cylinders. This anatomical deformity can cause pain and difficulty during sexual intercourse, ultimately leading to decreased satisfaction with the prosthesis2.
Management strategies include observation, utilization of vacuum erection devices, intraurethral suppositories, or surgical revision3. Surgical approaches may involve device upsizing, direct cut-downs to manage corporal fibrosis, or glanulopexy techniques. A modified glanulopexy technique described by Ziegelmann et al. involves passing a suture into the glans and securing it to the tissue overlying the corpora through small incisions on the lateral aspects of the distal penile shaft, which has shown promising results in correcting the deformity without reducing penile sensation4.