Crossover can occur without notice while introducing the Furlow or dilating. One can suspect crossover if the measurements are not equal on the right or left corpora. This can occur anatomically, since the septum between the two corpora is incomplete.
Crossover can occur both proximally and distally.
In the illustrated case, a distal crossover was not diagnosed intraoperatively. This patient had a right-to-left distal crossover pushing the left cylinder out of the corpora, and wound up with a deformed penis, glans hypermobility and pain — requiring revision of the implant.
When one detects crossover, the solution is to insert a large Hegar dilator into the corpora you crossed over to, and then re-dilate the other side. The Hegar will not allow the crossing side to pass again, allowing normal dilation. This way the cylinders will again be in their anatomically proper position.
Case Images
For medical professional education only. Patient-identifying details have been omitted.
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