Streamlined Approach for Infrapubic Placement of an Inflatable Penile Prosthesis

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Abstract

The streamlined approach for infrapubic placement of an inflatable penile prosthesis is a variation of the traditional infrapubic approach. A better understanding of operative techniques and recent clinical outcome studies have led to an evolution of the original infrapubic approach. Small incisions and efficient operative maneuvers can shorten operative times and expedite postoperative recovery.

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Most cited references 12

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The Henry mummy wrap and the Henry finger sweep surgical techniques.

Patrick Henry (2009)

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Inflatable penile prosthesis implantation without corporeal dilation: a cavernous tissue sparing technique.

Ignacio Moncada, Juan Ignacio Martínez-Salamanca, José Jara … (2010)

We compared the advantages and disadvantages of initial penile implantation with vs without prior dilation of the corpora cavernosa. Patients implanted for the first time with a 700CX or an antibiotic coated 700CX InhibiZone 3-piece prosthesis by a single surgeon during January 2005 to December 2006 were included in the study. They were randomized to penile implantation without (group 1) or with (group 2) penile dilation. Postoperative pain was measured on the day after surgery and at day 7 postoperatively. Perioperative and postoperative complications were recorded. Residual erectile activity without prosthesis inflation was evaluated using the International Index of Erectile Function at 3-month intervals for 9 months. Patients recorded penile length and girth during maximum sexual stimulation during this time. A total of 100 patients were included in the study. Intraoperative complications occurred in 2 group 1 and 3 group 2 patients. Postoperatively complication rates and types were similar in the 2 groups. Pain was significantly greater in group 2 (p <0.01). Immediately postoperatively, and at 3 and 6 months penile length was significantly greater in group 1 than in group 2 (p <0.05). Mean International Index of Erectile Function scores were higher in group 1 (12, range 10 to 14 vs 7, range 6 to 8). Results suggest that penile dilation is not necessary in primary implantation cases. 2010 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

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Outcomes of simultaneous placement of an inflatable penile prosthesis and a male urethral sling through a single perineal incision.

Vladislav Gorbatiy, Ouida Westney, Claudio Romero … (2010)

Synchronous implantation of an inflatable penile prosthesis (IPP) and a bulbourethral sling single via a single perineal is a unique approach in managing erectile dysfunction and stress urinary incontinence. This article describes our surgical approach and reviews the operative time, length of hospital stay (LOS), estimated blood loss (EBL), and cost of synchronous dual prosthetic implantation compared with the implants performed individually. Additionally, we review the short-term outcomes in patients with dual sling and penile prosthesis synchronous implants. Fifty-eight patients with IPP, 53 slings, and eight simultaneous dual implantations between January 2000 and July 2008 were retrospectively reviewed. Operative times, EBL, length of stay, cost, and complications were compared in three groups (group 1, IPP; group 2, slings; group 3, dual implants). Additionally, we reviewed pre- and postoperative Sexual Health Inventory for Men (SHIM) scores and pad use in group 3. Review of operative times, EBL, LOS, cost, and complications. Dual implantation had similar operative times compared with the total time for the individual procedures (98 +/- 24 minutes for IPP; 86 +/- 24 minutes for sling; 177 +/- 17 minutes for dual implant, P > 0.05). EBL was reduced (57 +/- 30 mL for IPP; 48 +/- 59 mL for sling; 49 +/- 5 mL for group 3). LOS was also reduced (1.2 +/- 0.45 days for IPP, 0.7 +/- 0.48 days for sling; and 1.1 +/- 0.50 days for dual implant). Dual implantation was associated with approximately $9,000 in savings. With a mean follow-up of 13.6 months, group 3 reported SHIM increase from 1.3 +/- 0.5 to 23.5 +/- 0.6 and a decrease in pad use from three pads per day (range 2-6) down to a mean of one pad per day (range 0-2). One sling erosion and one sling infection occurred in group 2. One patient in group 3 had acute urinary retention resolved with 5 days of catheter drainage. Dual penile prosthesis and bulbourethral sling implantation through a single perineal incision is safe, efficient, and cost-effective.

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Author and article information

Journal

Journal ID (nlm-ta): Adv Urol

Journal ID (iso-abbrev): Adv Urol

Journal ID (publisher-id): AU

Title: Advances in Urology

Publisher: Hindawi Publishing Corporation

ISSN (Print): 1687-6369

ISSN (Electronic): 1687-6377

Publication date (Print): 2012

Publication date (Electronic): 28 May 2012

Volume: 2012

Electronic Location Identifier: 520180

Affiliations

El Camino Urology Medical Group, Mountain View, CA 94040, USA

Author notes

*Edward Karpman: edwardkarpman@ 123456yahoo.com

Academic Editor: Gerard D. Henry

Article

DOI: 10.1155/2012/520180

PMC ID: 3368174

PubMed ID: 22693494

SO-VID: 7a92d04f-fb01-48cd-a679-bf7b82291366

License:

This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.