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The mean procedure time and injected volume were about 30 min and 6.6 ± 0.9 ml, respectively. This occurred despite close postoperative supervision and penile rehabilitation efforts with tadalafil 5 mg every other day, L-arginine 1000 mg daily, pentoxifylline 400 mg twice a day, and penile stretching and vacuum devices.31 Explants can be done via a circumcising incision and degloving, however we recommend a penile inversion approach to best access the distal implant tacking sutures.31 Although some authors report good results following explant and penile rehab,27,29 our group has described a case of significant curvature and penile retraction leading to loss of function (“penile cripple”) following the removal of an infected Penuma implant. Get the facts about what to expect from male-enhancement pills, pumps, exercises and surgeries. 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