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Sub-Coronal Inflatable Penile Prosthesis Placement With Modified No-Touch Technique: A Step-by-Step Approach With Outcomes
- Source :
- The Journal of Sexual Medicine. 13:270-276
- Publication Year :
- 2016
- Publisher :
- Oxford University Press (OUP), 2016.
-
Abstract
- Introduction The surgical treatment of disorders of male sexual function requires specific exposure to correct the underlying problem safely and efficiently. Currently, sub-coronal exposure is used for treatment of phimosis, Peyronie's disease plaque (PDP), and semirigid penile prosthesis insertion. Infra-pubic and scrotal incisions are used for inflatable penile prosthesis (IPP) placement. However, men who present with several disorders might require multiple procedures and surgical incisions. Aim To report a prospective review of our surgical experience and outcomes with a single sub-coronal incision for IPP placement with a modified no-touch technique. This approach allows for access to the entire corporal body for multiple reconstructive procedures. Methods Two hundred men had IPPs placed through a sub-coronal incision using our modified no-touch technique. The penis was degloved to the level of the penoscrotal junction and the dartos muscle was everted and secured to the drapes. This allowed exclusion of the scrotal and penile skin from the operative field. After artificial erection, the patient's corpora were inspected for PDP and other abnormalities. Penoscrotal IPP models were placed in all cases with insertion proximal to the penoscrotal junction. After placement of the IPP, the abnormalities were repaired. Main Outcome Measures Feasibility of the procedure, operative times, complication rate, utilization of accessory, reconstructive procedures, and post-operative penile length. Results Of the 200 men who had IPP placement, 92 had PDP that was treated, 106 (53%) consented to circumcision, 24 (12%) had their reservoir placed ectopically, and 31 (16%) had a prosthesis exchanged through the sub-coronal technique. Mean operative time was 73 minutes (39–161 minutes). Conclusion Specialists in the surgical treatment of disorders of male sexual function can perform multiple procedures safely and easily through a modified no-touch single sub-coronal incision. This approach allows access to the entire corporal body, providing excellent visibility and allowing the surgeon to perform multiple penile reconstructive surgeries through a single incision.
- Subjects :
- Adult
Male
medicine.medical_specialty
Urology
Endocrinology, Diabetes and Metabolism
medicine.medical_treatment
Penile Induration
030232 urology & nephrology
Prosthesis Implantation
Prosthesis Design
Prosthesis
03 medical and health sciences
0302 clinical medicine
Endocrinology
Erectile Dysfunction
Scrotum
medicine
Humans
Prospective Studies
030219 obstetrics & reproductive medicine
business.industry
Penile Erection
Penile prosthesis
Middle Aged
Plastic Surgery Procedures
medicine.disease
Surgery
Psychiatry and Mental health
Treatment Outcome
medicine.anatomical_structure
Erectile dysfunction
Reproductive Medicine
Patient Satisfaction
Penile Prosthesis
Peyronie's disease
business
Penis
Subjects
Details
- ISSN :
- 17436095
- Volume :
- 13
- Database :
- OpenAIRE
- Journal :
- The Journal of Sexual Medicine
- Accession number :
- edsair.doi.dedup.....87b7fdf60408a6a867624cfc993896a9
- Full Text :
- https://doi.org/10.1016/j.jsxm.2015.12.016