Penile prosthesis implant for erectile dysfunction: A new minimally invasive infrapubic surgical technique

Antonini, Gabriele; Busetto, Gian Maria; Berardinis, Ettore De; Giovannone, Riccardo; Vicini, Patrizio; Gentile, V.; Perito, Paul

doi:10.4081/aiua.2015.4.322

Cited by 4 publications

(1 citation statement)

References 19 publications

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“…We utilize a minimally invasive infrapubic approach for our penile implant placement (20,21). Patients are required to void to completion just prior to entering the operative suite and a foley catheter is typically not used.…”

Section: Description Of Techniquementioning

confidence: 99%

Midline reservoir placement for inflatable penile implant: Initial experience

Raheem¹,

Suarez‐Sarmiento²,

Demzik³

et al. 2023

Preprint

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Placement of a 3-piece inflatable penile prosthesis (IPP) serves as definitive treatment for erectile dysfunction, and we sought to examine an alternative reservoir placement technique using the midline approach in patients with previous pelvic surgery. We highlight and describe the authors’ initial experience of midline reservoir placement for inflatable penile prosthesis. We collected data from patients with a history of bilateral inguinal surgery, unilateral herniorrhaphy, or a pre-operative physical exam revealing bilaterally patulous inguinal rings. The midline approach was performed on all patients undergoing IPP meeting the inclusion criteria from Feb 2018 to May 2020. Both virgin and revision IPP cases included. Intraop and postop morbidities were recorded. A segmented numeric version of the visual analog scale (VAS) was utilized to reflect pain intensity directly related to the midline approach to reservoir placement. Patients were evaluated for lower urinary tract symptoms in the preoperative and postoperative setting using the International Prostate Symptom Score (IPSS). A total of 125 (2 AMS 700 and 123 Coloplast Titan) patients underwent infrapubic IPP procedures utilizing midline reservoir placement. Of the 125 midline reservoir placements, 39 were revision cases, 3 of which underwent only reservoir exchange. The VAS (VAS range 0-10) was used to assess pain within one and at four weeks of follow-up. Midline reservoir placement was associated with minimal pain at the reservoir site, with all patients reporting a score of 1 at the four week follow up. Overall pain was also assessed with the VAS. At 1 week, mean VAS score was 1.86 (median 1, range 0-7). At four weeks, the mean overall VAS score was 0.56 (median 0, range 0-6). We describe a midline IPP reservoir placement that allows the surgeon to safely and effectively access the area posterior to the abdominal wall thereby precluding device palpability, while decreasing operative time, and minimizing patient reported pain at the reservoir site.

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Section: Description Of Techniquementioning

confidence: 99%

Midline reservoir placement for inflatable penile implant: Initial experience

Raheem¹,

Suarez‐Sarmiento²,

Demzik³

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

Comparison of Infrapubic vs Penoscrotal Approaches for 3-Piece Inflatable Penile Prosthesis Placement: Do We Have a Winner?

Palmisano

Boeri

Cristini

et al. 2018

Sexual Medicine Reviews

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Shaeer’s infrapubic technique for penile prosthesis implantation through a single midline corporotomy: A single-center pilot study

Shaeer

2023

The Journal of Sexual Medicine

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Background With the infrapubic approach (IPA) for penile prosthesis implantation, lateral corporotomies carry the risk of injury to the laterally coursing dorsal nerves. Aim We sought to describe for the first time Shaeer’s IPA, a modification of the IPA whereby malleable penile prosthesis cylinders are implanted through a single midline corporotomy in the bed of the deep dorsal vein, anatomically off the course of the dorsal nerves of the penis. Methods We compared semirigid penile prosthesis implantation via the single midline corporotomy IPA (IPA-S, n = 11) to the classic IPA with laterally placed dual corporotomies (IPA-D, n = 11) and to the penoscrotal approach (PSA; n = 13). Shaeer’s IPA is performed through an infrapubic incision. A 3- to 5-cm length of the deep dorsal vein is stripped. A single 3- to 5-cm midline corporotomy is cut along the bed of the vein. Dilation, sizing, and implantation are performed through the single corporotomy on either side of the midline septum. Patients are discharged the same day and are allowed to bend the implant after 2 weeks and to commence intercourse after 3 weeks. Outcomes Operative time, postoperative satisfaction, International Index of Erectile Function 5 (IIEF-5), and possible complications were recorded. Results There were no statistically significant differences in age, postimplantation IIEF-5, or satisfaction between the 3 groups. Average operative time for the IPA-S group was 21.8% shorter than that for the IPA-D group, and 34.5% shorter than for the PSA group. Those differences were statistically significant. No complications were recorded in the IPA-S group. Infection occurred in 1 PSA case, and partial hypoesthesia in 1 IPA-D case. Clinical Implications The midline corporotomy confers an anatomical advantage that may help avoid nerve injury, thereby increasing the safety of the IPA. Strengths and Limitations The main limitation of this study is the limited sample number, considering that this is a pilot study. Conclusion The Shaeer’s Midline-Corporotomy IPA is a minimally invasive technique for implantation of a semirigid penile prosthesis, with an anatomical advantage that may decrease the possibility of dorsal nerve injury.

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Penile prosthesis implant for erectile dysfunction: A new minimally invasive infrapubic surgical technique

Cited by 4 publications

References 19 publications

Midline reservoir placement for inflatable penile implant: Initial experience

Midline reservoir placement for inflatable penile implant: Initial experience

Comparison of Infrapubic vs Penoscrotal Approaches for 3-Piece Inflatable Penile Prosthesis Placement: Do We Have a Winner?

Shaeer’s infrapubic technique for penile prosthesis implantation through a single midline corporotomy: A single-center pilot study

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