“Pioneros en Sur America en emplante de protesis peneana por via infrapubica” featured Dr. Perito as a pioneer in bringing his minimally invasive infrapubic implant technique to Colombia for the first time. To see the translation, see below:
“As interest in “different” or “novel” approaches to penile implant surgery abound, Colombia’s Excelencia Magazine and Dr. Cesar Augusto Gonzalez Encinales featured the first minimally invasive infrapubic approach to penile prosthesis ever in the history of Columbia. It will be interesting to see which implantors adopt the minimally invasive approach. Regardless, Colombia urologists remain some of the most advanced specialist in the world.”
– Dr. Perito
For the first time in Colombia, the Central Hospital of the National Police
performed two procedures of this nature, directed by the maximum authority on the subject, American doctor Paul Perito.
The missionality of the Directorate of Health of the National Police demands to be at the forefront in technology and medical treatments in pleasing the health of its users. An example of this practice was introducing the infrapubic technique during the placement of penile prosthetic to treat advanced stage erectile dysfunction.
Although penile implants were already being placed scrotal route in the Central Hospital for more than three years, and with very good results, the infrapubic technique offers advantages, such as a reduction in surgical time, which is reduced by about 2 and half hours. Secondly, the placement of implant by penile scrotal technique requires an incision
seven centimeters, with the infrapubic technique performed through a small incision of only 2cm, at the bottom of the pubis, which in turn reduces the hospital stay to one night rather than 3.
Another great advantage is that the patient can start inflating the implant sooner, in about eight days as opposed to 1 month. The infrapubic technique has now been done in Colombia and more than 95 percent of andrological centers
of the world, it was developed and implemented in the United States by doctor
Paul Perito, men’s health specialist and penile implanter from the city of
Coral Gables, in Miami, FL. With approximately 20 years of experience in men’s sexual health and erectile dysfunction, he is a world leader in his field having now performed more than 7000 penile implants and authored multiple publications and medical articles in both the United States and around the world.
Dr. Paul was in charge of training to uroandrologists and general urologists
of the Directorate of Health, in the Course Advanced Penile Implants performed
at the Central Hospital on July 14, not only as a speaker, but also
with the accompaniment in the realization of the first two infrapubic implants performed in
For these procedures we selected two patients, one with diagnosis
of insulin-dependent diabetes mellitus, and the other with a history of radical prostatectomy for prostate cancer, both with erectile dysfunction beyond treatment with oral and injection therapies. Both procedures were performed in approximately 45 minutes, without complications and with satisfactory evolution in postoperative controls.
Erectile dysfunction, which is defined as the consistent disability to achieve and / or maintain an erection adequate to complete a satisfactory sexual relationshipincreases with age, particularly after the age of 50, it is estimated to have an effect on more than 50
percent of the male population.
To have reached this advanced technique, was an evolutionary process as the Directorate of Health. Because of the high demand of consultation for erectile dysfunction in
the global scope, physicians at the beginning of the 1980’s began to perform various surgeries to treat arterial insufficiencies in the vascular structures of the penis.
In the middle of the 80s it was intracavernous therapy was discovered and applied widely. Vasoactive drugs, and at end of the same decade and vacuum devices were introduced
to treat erectile dysfunction, however, these aggressive and bulky methodologies were
not exempt from possible complications and produced a low acceptance and adherence rate on the part of the patients.
In the second half of the 90s, intraurethral therapy with vasoactive drugs was developed,
and used in clinical practice where they demonstrated an effectiveness lower than expectations. In 1998 the first oral drug was approved and marketed effective, sildenafil citrate, a PD5 inhibitor with characteristics very close to what had been considered should be a drug ideal to treat this pathology.
Since then oral medications are considered the first line of treatment
for erectile dysfunction. Nevertheless and even though there are a lot of
treatment options, there are a large number of patients who do not respond to these therapies, which is the reason why they began to develop implantable devices. These began as malleable or semi-rigid, and now include Inflatable three-component prosthesis, which revolutionized the management of erectile dysfunction for patients who do not respond to oral therapies or injectable. Now, the most favorable and advanced technique for penile implantation remains the infrapubic technique.