The Minimally Invasive Infrapubic Approach for placement of a 3 piece Inflatable Penile Prosthesis

Author: Paul E. Perito

Key words: Penile Implant, Infrapubic

The video covers the infrapubic placement of an inflatable penile implant.  Through a 2cm infrapubic incision a three-piece penile implant can be inserted routinely in under 20 minutes.  In this video, we condense our 11-minute case into a 5-minute tutorial that covers what you need, the essential steps and nothing else.  This 15-step approach, originally described in 2007, capitalizes on the conservation of motion and dissection leading to rapid rehabilitation.  Our approach uses a small incision, hydro dilation, small corporotomies with preplaced closing sutures, elimination of serial dilation, alternative reservoir placement, standardized pump placement and finally a drain.  The minimally invasive approach to a penile implant can be performed under any type of anesthesia including local.  Surgeons can familiarize themselves with the procedure and rapidly incorporate some or all of these skills into any approach.  The procedure has a published return to normal sexual function rate of greater than 80% of our patients in under 4 weeks.  Indeed, now our patients are resuming sexual activity at two and three weeks.   By removing the obstacle to rapid rehabilitation, an incision on the scrotum, the infrapubic approach to penile implantation is rapidly becoming the “go to” approach for patients searching for a definitive surgical treatment for erectile dysfunction.

Acknowledgements: S.K. Wilson MD, FACS, Annah Vollstedt MD, Martin Gross MD, M. Perito

Disclosures : Consultant - Coloplast, Boston Scientific

References :

  1. Perito PE.: Minimally Invasive Infrapubic Inflatable Penile Implant. Journal of Sexual Medicine, 5(1), 27-30. 2008.
  2. Perito P.E, Stember D.S, Garber B.B:  Outcomes of Abdominal Wall Reservoir Placement in Inflatable Penile Prosthesis Implantation:  A Safe and Efficacious Alternative to the Space of Retzius.  The Journal of Sexual Medicine, 11:  605-612, 2014