Efficient Penoscrotal Approach for Multiple Penile Procedures

Authors: Jayson Kemble, Eileen Byrne, Lexiaochuan Wen, J Nicholas Warner, Sevann Helo, Matt Ziegelmann, Tobias S Köhler

Key Words: Penile Prosthesis; Infection; Surgical Time; Surgical Technique

The penoscrotal approach for inflatable penile prosthesis (IPP) implantation accounts for >80% of IPPs placed worldwide. This approach can also be used in Malleable implant placement and in scrotal decompression of priapism. Efficient and effective exposure with this approach can be challenging in inexperienced hands, with longer surgical times associated with an increased risk of infection. Here we demonstrate an efficient exposure for IPP up to corporal dilation using the penoscrotal approach.

Acknowledgements: None

Disclosures: Consultant for Coloplast

References:

1. Fuchs JS, Shakir N, McKibben MJ, Mathur S, Teeple S, Scott JM, Morey AF. Penoscrotal Decompression-Promising New Treatment Paradigm for Refractory Ischemic Priapism. J Sex Med. 2018 May;15(5):797-802.
2. Köhler TS, Wen L, Wilson SK. Penile implant infection prevention part 1: what is fact and what is fiction? Wilson's Workshop #9. Int J Impot Res 2020; 33(8):785-792.
3. Onyeji IC, Sui W, Pagano MJ, Weinberg AC, James MB, Theofanides MC, Stember DS, Anderson CB, Stahl PJ. Impact of surgeon case volume on reoperation rates after inflatable penile prosthesis surgery. The Journal of Urology 2017; 1;197(1):223-9.
4. Wang Q, Goswami K, Shohat N, Aalirezaie A, Manrique J, Parvizi J. Longer operative time results in a higher rate of subsequent periprosthetic joint infection in patients undergoing primary joint arthroplasty. The Journal of Arthroplasty 2019; 34(5):947-53.