Suprapubic Fat Pad Excision with Simultaneous Placement of Inflatable Penile Prosthesis

VJPU 2016; 2: 091

Authors: Adam S. Baumgarten, Jonathan A. Beilan, Michael W. Bickell, Gerard D. Henry, Rafael E. Carrion

Key words: Penile implant, Suprapubic fat pad excision

Placement of inflatable penile prosthesis (IPP) is a common urologic surgery that has been proven to have durable effect in the treatment of erectile dysfunction (ED). Many men suffering from ED are significantly overweight and have generous suprapubic fat pads, which can contribute to decreased visible exophytic phallic length. We present a novel surgical concept of suprapubic fat pad excision with concomitant placement of IPP. A transverse incision is made starting 2 cm inferior and medial to the ASIS and carried across the infrapubic region in a curvilinear fashion, passing approximately one finger breath above the base of the penis. The incision continues in a symmetric fashion to the contralateral side. Dissection is carried down to the lower abdominal anterior fascia, which leads to excision of the suprapubic fat pad. Using this same exposure, the IPP is placed via an infrapubic approach following our standard protocol for prosthetic insertion. The wound is reapproximated and two drains are placed, one subcutaneous in the area of the fat pad excision and the other in the scrotum around the pump. This procedure can lead to higher patient satisfaction with their penile implant, enhanced sexual performance, and improved quality of life for patients with concurrent erectile dysfunction and significant suprapubic fat pad.

Acknowledgements: None

Disclosure: The authors have nothing to disclose