Virgin Penoscrotal Inflatable Penile Implant

VJPU 2018; 2: 117

Title: Virgin Penoscrotal Inflatable Penile Implant

Authors: Koenraad van Renterghem

In this video we demonstrate the implantation of an Inflatable Penile Implant in a “virgin” case. Surgery is performed using a single transverse penoscrotal incision. In our approach we start with dissecting the urethra up to the bulbar region allowing us to prepare both corpora easily without any risk of damaging the corpus spongiosum. For this purpose we use a Babcock clamp so we can mobilise the urethra to either side. The stay sutures on both corpora are executed with vicryl 1, “W” shaped with cutting of the loop and the needle. Doing this we have 4 stay sutures with little effort and without any risk of perforating the cylinders when in place. Dilating is done with Brooks dilators, we use only 2 or maximum 3 different sizes.

The reservoir is placed paravesical and extraperitoneal, here we use again a stay suture Vicryl 1 on the external oblique muscle fascia. This prevents later herniation of the reservoir as can be seen in rare cases. The cylinders should be well located on both sides, as well proximal and distal. A correct distal positioning will prevent a floppy glans. Finally the pump is placed between both testicles. We routinely do not drain.
Doing this surgery as demonstrated in this video with a well experienced assisting team, we are able to have an operating time that does not exceed 30 minutes in general.

Acnowledgements: None

Disclosures: consultant for Boston Scientific and Coloplast.

References:

  1. Henry GD, Mahle P, Caso J, Eisenhart E, Carrion R, Kramer A. Surgical techniques in penoscrotal implantation of an inflatable penile prosthesis: a guide to increase patient satisfaction and surgeon ease. Sex Med Rev 2015 Mar; 3(1): 36-47
  2. Gupta N, Ring J, Trost L, Wilson S, Köhler T. The penoscrotal approach for inflatable penile prosthesis placement. Transl Androl Urol 2017 Aug; 6(4): 628-638