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Ghattas modification of inflatable penile prosthesis: a proposed surgical technique for efficient penile prosthesis implantation

International Journal of Impotence Research (2024)Cite this article

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Implantation of inflatable penile prostheses (IPPs) has been established as a pivotal interventional option for patients suffering from erectile dysfunction with increased popularity in the past few decades. Data from the United States, which is the largest consumer country for IPPs, showed that a total of 54,146 implantation surgeries were performed between 2005 and 2012 with over half being IPPs [1]. During the implantation of the three-piece IPPs, the step of reservoir implantation may necessitate additional time and expertise. The reservoir is most commonly implanted in either the retropubic space of Retzius (the standard approach for placement) or the intra-abdominal submuscular space (the ectopic approach). Faulty reservoir placement technique can lead to complications such as displacement and subcutaneous reservoir resulting in bulging and disfigurement. Both techniques for insertion were described in a recent article by Gupta et al. [2]. The ectopic approach relies on retracting the external inguinal ring to create a space just above the pubic tubercle and under the Scarpa’s fascia to ensure a submuscular insertion instead of an intramuscular one. Since the first penile implant was introduced in 1973, there have been several advances in the devices’ design over years. We describe a novel advancement in the standard implantation technique of IPP through reservoir adjustment.

For the proposed adjusted modification in the reservoir, using this approach is suggested to decrease the learning curve for young surgeons. Likewise, this can also reduce time of implantation which can lead to a decreased rates of infection post- operatively. It was reported that a shorter surgical time is associated with less post-operative infection rates [3]. It is also established that surgeon’s experience can play a paramount role in the resulting infection and reoperation rates [4, 5]. Moreover, patients can benefit during the recovery times since using this method can prevent reservoir movement and decrease the probability for tubes rotation which can be associated with reservoir displacement leading to leakage and blockage of fluid transportation.

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Fig. 1: Illustration of the suggested modification and surgical technique.

References

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Acknowledgements

We would like to acknowledge Dr. Yossef Hassan AbdelQadir, who recently passed away, for his help and advice during the preparation of this correspondence. His dedication and efforts will be always remembered by our team.

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Authors and Affiliations

  1. Dar-elzokora Center of Andrology, Alexandria, Egypt

    Osama Ghattas

  2. Department of Urology, Faculty of Medicine, Ain Shams University, Cairo, Egypt

    Moustafa Gaber Menshawy

Authors
  1. Osama Ghattas
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  2. Moustafa Gaber Menshawy
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Contributions

OG developed the future vision of the reservoir in addition to the surgical technique, prepared the supporting images for illustration, and revised and edited the manuscript. MGM shared in the writing and editing of the manuscript. Dr. Osama Ghattas is the guarantor of idea and has the intellectual property for this design.

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Correspondence to Osama Ghattas.

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Ghattas, O., Menshawy, M.G. Ghattas modification of inflatable penile prosthesis: a proposed surgical technique for efficient penile prosthesis implantation. Int J Impot Res (2024). https://doi.org/10.1038/s41443-024-00848-z

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  • DOI: https://doi.org/10.1038/s41443-024-00848-z

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