The Minimally Invasive Infrapubic Penile Prosthesis: Our most recent 1000
Objective. Analysis of a simplified approach for infra-pubic IPP and review of efficacy, post-operative morbidity, and patient return to function.
Methods. Retrospective review of N = 1032 IPPs (Jan 2010- May 2012) from one surgeon. All cases were Coloplast Titan 3-piece IPP’s. 823 patients were original implants (80%), 185 revisions (18%) and 29 reimplants (2%). Patients received similar pre/intra-operative antibiotic prophylaxis (flouroquinolone/hibiclens 24-hours before the procedure and Vancomycin/Gentamycin pre-op). The Minimally Invasive approach was presented (SMS 12/07), modifications include: no catheter, no dilation unless the “Scratch” technique was utilized, only125cc reservoirs are utilized. All patients receive a #7 JP drain (removed the following day). Patients were reviewed post-op for six-weeks. All complications were reported.
Results. The Minimally Invasive (Perito Penile Implant) technique was easily reproduced in 574(70%) virgin cases. The remaining 247(30%) virgin cases required ancillary techniques (i.e. Modeling/Scratch). All revision cases were conducted via infra-pubic technique regardless of initial approach. 11 infections (.94%) occurred and 10 (90%) were successfully salvaged. Two mid urethral injuries occurred and were aborted. Two patients showed significant scrotal hematoma and required drainage. No patients experienced glandular anesthesia or hypoesthesia after six-weeks. (90%) of patients were instructed to resume sexual function at four-weeks and balance of patients by six-weeks.
Conclusion. The Minimally Invasive infra-pubic IPP is safe, efficacious and offers patients a rapid return to sexual function. Post-op outcomes mirror clinical literature of other approaches.
In October Dr. Perito will visit both Rio De Janeiro and Sao Paulo Brazil as well as Australia where he will work with their top implanters educating them on new techniques in penile implantation and the treatment of Peyronie’s Disease.