Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Analysis of the effects of different surgical approaches on corporotomy localization in inflatable penile implant surgery performed by expert implant surgeons

Abstract

Inflatable penile prostheses may be a solution for patients with erectile dysfunction. To our knowledge, no data exist regarding the effect of different surgical approaches used during implantation on the site of the corporotomy. The main purpose of this multicentre study was to investigate the influence of different surgical approaches on the corporotomy site.

Data were collected from six expert implant surgeons. Surgical notes were searched for the incision site, proximal, distal and total corporal length measurement, total cylinder length, length of rear tip extenders, surgery time, type of implant, and reservoir placement. The association between the proximal/distal corporal length and the recorded covariates was examined using a linear mixed model.

A total of 1757 patients who underwent virgin prosthesis implantation were included in the analysis. Analysis of proximal/distal measurements was performed on 1709 patients. The proximal/distal ratio had a mean of 0.8 ± 0.3 in penoscrotal incisions (n = 391), 0.7 ± 0.2 in infrapubic incisions (n = 832) and 0.7 ± 0.2 in subcoronal (n = 486) incisions. We observed no significant differences in proximal/distal measurements between the highest-volume surgeons.

We could not draw a firm conclusion about the difference in corporotomy site between different surgical approaches, but we found no significant difference between the highest-volume surgeons using different techniques.

This is a preview of subscription content, access via your institution

Access options

Buy article

Get time limited or full article access on ReadCube.

$32.00

All prices are NET prices.

Fig. 1: Box plot of proximal/distal length by surgeon and incision technique.
Fig. 2: Box plot of total length by surgeon and incision technique.

Data availability

The datasets generated during and analysed during the current study are available from the corresponding author on reasonable request.

References

  1. Scott FB, Bradley WE, Timm GW. Management of erectile impotence. Use of implantable inflatable prosthesis. Urology. 1973;2:80–2.

    CAS  Article  Google Scholar 

  2. Antonini G, Busetto GM, De Berardinis E, Giovannone R, Vicini P, Del Giudice F, et al. Minimally invasive infrapubic inflatable penile prosthesis implant for erectile dysfunction: evaluation of efficacy, satisfaction profile and complications. Int J Impot Res 2016;28:4–8. https://doi.org/10.1038/ijir.2015.33.

    CAS  Article  PubMed  Google Scholar 

  3. Barton GJ, Carlos EC, Lentz AC. Sexual quality of life and satisfaction with penile prostheses. Sex Med Rev. 2019;7:178–88.

    Article  Google Scholar 

  4. Hakky T, Lentz A, Sadeghi-Nejad H, Khera M. The evolution of the inflatable penile prosthesis reservoir and surgical placement. J Sex Med. 2015;12:464–7.

    Article  Google Scholar 

  5. Mykoniatis I, Osmonov D, van Renterghem K. A Modified surgical technique for reservoir placement during inflatable penile prosthesis implantation. Sex Med. 2020;8:378–82.

    Article  Google Scholar 

  6. van Renterghem K, Jacobs B, Yafi F, Osmonov D, Ralph D, Venturino L, et al. Current practices regarding corporotomy localization during penoscrotal inflatable penile implant surgery: a multicenter cohort study. Int J Impot Res. 2022;34:302–7.

    Article  Google Scholar 

  7. Houlihan MD, Köhler TS, Wilson SK, Hatzichristodoulou G. Penoscrotal approach for IPP: still up-to-date after more than 40 years? Int J Impot Res. 2020;32:2–9.

    Article  Google Scholar 

  8. Picola Brau N, Torremadé J. Infrapubic surgical approach for penile prosthesis surgery: Indications and technique. Actas Urol Esp. 2020;44:301–8.

    CAS  Article  Google Scholar 

  9. Weinberg AC, Pagano MJ, Deibert CM, Valenzuela RJ. Sub-coronal inflatable penile prosthesis placement with modified no-touch technique: a step-by-step approach with outcomes. J Sex Med. 2016;13:270–6.

    Article  Google Scholar 

  10. Chung E. Penile prosthesis implant: scientific advances and technological innovations over the last four decades. Transl Androl Urol. 2017;6:37–45.

    Article  Google Scholar 

  11. Otero JR, Manfredi C, Wilson SK. The good, the bad, and the ugly about surgical approaches for inflatable penile prosthesis implantation. Int J Impot Res. 2022;34:128–37.

    Article  Google Scholar 

  12. Gregory JG, Purcell MH, Standeven J. The inflatable penile prosthesis: failure of the rear tip extender in reducing the incidence of cylinder leakage. J Urol. 1984;131:668–9. https://doi.org/10.1016/s0022-5347(17)50569-8.

    CAS  Article  PubMed  Google Scholar 

  13. Thirumavalavan N, Cordon BH, Gross MS, Taylor J, Eid J-F. The rear tip extender for inflatable penile prostheses: introduction of “rigidity factor” and review of the literature. Sex Med Rev. 2019;7:516–20.

    Article  Google Scholar 

  14. Scarzella GI. Cylinder reliability of inflatable penile prosthesis. Experience with distensible and nondistensible cylinders in 325 patients. Urology. 1988;31:486–9.

    CAS  Article  Google Scholar 

  15. Malloy TR, Wein AJ, Carpiniello VL. Improved mechanical survival with revised model inflatable penile prosthesis using rear-tip extenders. J Urol. 1982;128:489–91.

    CAS  Article  Google Scholar 

  16. Kenneth DeLay, Andrew Gabrielson, Faysal Yafi, Wayne Hellstrom. Pd22-06 rear tip extenders during inflatable penile prosthesis placement: impact on need for revision. J Urol. 2017;197:e443–4.

    Google Scholar 

  17. Lynn R. Rushton’s r–K life history theory of race differences in penis length and circumference examined in 113 populations. Personal Individ Differ. 2013;55:261–6.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Contributions

NL: Corresponding author responsible for acquiring data, writing and submission of the manuscript and revisions. KVRG: Corresponding author who designed the work that led to the submission and played an important role in interpreting the results. Revised the manuscript. Approved the final version. DO: Acquired data. Revised the manuscript. AS: Acquired data. Revised the manuscript. PP: Acquired data. Revised the manuscript. PS: Acquired data. Revised the manuscript. RA: Acquired data. Revised the manuscript. RD: Acquired data. Revised the manuscript. IM: Revised the manuscript. Approved the final version.

Corresponding authors

Correspondence to N. L. Lauwers or K. Van Renterghem.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Lauwers, N.L., Van Renterghem, K., Osmonov, D. et al. Analysis of the effects of different surgical approaches on corporotomy localization in inflatable penile implant surgery performed by expert implant surgeons. Int J Impot Res (2022). https://doi.org/10.1038/s41443-022-00593-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1038/s41443-022-00593-1

Search

Quick links