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Nuances of infrapubic incision for inflatable penile prosthesis

International Journal of Impotence Research volume 34, pages 524–533 (2022)Cite this article

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Abstract

This workshop completes the trilogy of nuances of the various incisions used to place an inflatable penile prosthesis (IPP). Infrapubic placement was the original technique employed 50 years ago for the very first IPP surgeries. The historical perspective of the development of implantation incisions and the original Scott prosthesis highlighted in this work should be fascinating to today’s younger prosthetic urologists. The developing surgeon should also find some surprising maneuvers considered important technique nuances from the highest volume infrapubic implanter in the world. Among the wonders of the infrapubic approach covered are: The surgery is conducted without the aid of an in-dwelling Foley catheter or post-operative inflation. Hydrodistension of the corpora substitutes for corporal dilatation. The “chicken choke” protects the urethra from damage. Closed suction drainage is employed despite minimal scrotal dissection. Motivated patients may use their new device as early as 14 days after implantation.

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Fig. 1: Historical pictures of infrapubic implantation.
Fig. 2: Drs William Furlow & Brantley Scott IPP tool inventions.
Fig. 3: Development of AMS 700 IPP cylinders.
Fig. 4: IPP through an infrapubic incision.
Fig. 5: Instrumentation to facilitate infrapubic IPP.
Fig. 6: Stay sutures facilitate corporotomy.
Fig. 7: Work along axis of penis when dilating/measuring.
Fig. 8: Fossa navicularis has weakest tunica albuginea anatomy.
Fig. 9: Reservoir placements through infrapubic incision: PTF & ATF.
Fig. 10: Placement of reservoir facilitated by nasal Speculum & Yankaur.
Fig. 11: Deployment of cylinders.
Fig. 12: Surrogate reservoir test for penile deformity & proper pump positioning.

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Authors and Affiliations

  1. Department of Urology, Perito Urology, Coral Gables, FL, USA

    Paul Perito

  2. Department of Urology, University of Alabama, Birmingham, AL, USA

    John Mulcahy

  3. Department of Urology, Mayo Clinic, Rochester, MN, USA

    Lexiaochuan Wen

  4. Department of Urology, Institute for Urologic Excellence, La Quinta, CA, USA

    Steven K. Wilson

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  1. Paul Perito
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  2. John Mulcahy
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Correspondence to Lexiaochuan Wen.

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Conflict of interest

Perito: Consultant Boston Scientific, Coloplast. Mulcahy: Consultant Boston Scientific, Coloplast. Wen: None. Wilson: Consultant AMT, Coloplast, International Medical Devices, Lecturer Boston Scientific. Stockholder NeoTract.

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Perito, P., Mulcahy, J., Wen, L. et al. Nuances of infrapubic incision for inflatable penile prosthesis. Int J Impot Res 34, 524–533 (2022). https://doi.org/10.1038/s41443-020-00370-y

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