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Nuances of infrapubic incision for inflatable penile prosthesis


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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Correspondence to Lexiaochuan Wen.

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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).

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