Perito Urology ends 2017 with 50th Educational Program of the Year

Dr. Paul Peritoeducation, IPP Technique

50th Training

December 15, 2017

Perito Urology hosted five international physicians from Colombia and Chile on December 15th, completing its 50th educational program of 2017.

With urologists from Latin America, we performed 11 penile implants and shared war stories of the implants past.  One thing is really apparent, all cultures enjoy good sex and would do just about anything to have it!  Doctors Palma, Marconi, Pabon, Garcia, and Echeverry help us close out the year of training programs with class.  Ask them and they will share their new found passion for the infrapubic approach!

Dr. Perito

Dr. Perito comments on “The PENIS Book” by Dr. Aaron Spitz

Dr. Paul Peritoeducation, erectile dysfunction, penile implant

December 2017

The Penis Book

Let my start by saying the penis is funny! What many do not know about Aaron Spitz, MD, chief representative for America’s urologists to the American Medical Association, is that he once was a stand-up comedian and a good one. This adjunct to his training courses smoothly through The Penis Book making it a must-read for anyone who finds the penis both funny and essential. From the “Fake News” on circumcision and penile enlargement to the rational treatments for anejaculation and erectile dysfunction, Dr. Spits nails it! I have seen more penises than most during my career, and this book will remain on my desk as both a reference and a joy to re-read.

– Dr. Perito

Dr. Perito featured in Colombia’s Policia Nacional Publication

Dr. Paul Peritoerectile dysfunction, IPP Technique

Dr Perito in Colomboa

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
Colombia.

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.

 

 

Dr. Perito Co-Authors Paper on Penile Implant Safety

Dr. Paul Peritoerectile dysfunction, IPP Technique, penile implant

In our never ending quest to make penile implant reservoir placement safe for all implanters, we have identified a very small subset of patients (smokers and patients with low BMI’s) who may be at risk for adverse events.  The incidence of complications was so low that they almost could be considered case reports.  But, careful identification of the space posterior to transversalis fascia in these patients should preclude any bowel, bladder, vascular injury or hernia.

El Implante Perito® Presentado a Urologo’s en Cuba

Dr. Paul Peritoerectile dysfunction, penile implant

El Dr. Gabriele Antonini ha comenzado a entrenar a urólogos y cirujanos en La Habana, Cuba en el implante de pene inflable de tres piezas desarrollado y pionero por el Dr. Paul Perito. Este procedimiento conlleva un riesgo significativamente menor de infección y complicación que otras técnicas de implante de pene, ya que se realiza a través de la parte inferior del abdomen en lugar de a través del pene o escroto, y normalmente tarda sólo 20 minutos para realizar.

Dado el alto calibre de las instalaciones médicas y la experiencia en Cuba y su accesibilidad desde América Central y del Sur, esto representa una oportunidad emocionante para poder traer una opción quirúrgica más segura para tratar la disfunción eréctil a áreas del mundo donde no hay tanto conciencia sobre la prótesis del pene.

Para leer la cobertura de la prensa sobre las sesiones de capacitación del Dr. Antonini, por favor vea los siguientes enlaces:

The Perito Implant® Introduced to Urologists in Cuba

Dr. Paul Peritoerectile dysfunction, penile implant

Dr. Gabriele Antonini has begun training urologists and surgeons in Havana, Cuba in the three piece inflatable penile implant developed and pioneered by Dr. Paul Perito. This procedure carries a significantly lower risk of infection and complication than other penile implant techniques as it is performed through the lower abdomen rather than through the penis or scrotum, and typically takes only 20 minutes to perform.

Given the high caliber of medical facilities and expertise in Cuba and its accessibility from Central and South America, this represents an exciting opportunity to be able to bring a safer surgical option to treat erectile dysfunction to areas of the world where there isn’t as much awareness about penile prosthesis.

“Dr. Antonini breaks into another new frontier for men’s health.  We are looking forward to joining him in caring for men from Cuba, the Caribbean, and all around the World.”
-Dr. Perito

To read the Spanish version of this blog, click here.

To read the press coverage about Dr. Antonini’s training sessions, please see the below links:

Dr. Perito Presents ‘Penile Prosthetics in Aesthetics’ at Las Vegas Conference

Dr. Paul Peritogirth enhancement

July 2017

Recently a man succumbed to a fat embolism suffered during an attempt at penile girth enhancement with a free fat transfer. He was an otherwise healthy 30-year-old man. This clinical scenario is one of the many complications of penile girth enhancement I have warned my colleagues about.

Recently at the 2017 Aesthetics Show in Las Vegas I proctored a course on “Penile Prosthetics in Aesthetics.” To date, there have been no viable options for routine penile girth enhancement that are both safe and efficacious. For this reason, we have been working with the filler HA for the last 6 years and will soon complete a large, long term study demonstrating complication free penile girth enhancement with excellent functional and cosmetic results.

I encourage my colleagues in plastic/aesthetics to wait until these trials are completed because we believe that our technique provides the first reproducible method for penile girth enhancement that is free of any significant complications.

– Dr. Perito

The Aesthetic Show

the Aesthetic Show 2017

Dr. Perito Attends & Proctors Surgical Workshop in Colombia

Dr. Paul Peritoerectile dysfunction, IPP Technique, penile implant, Peyronie's Disease

July 13-14

Dr. Perito attended and proctored a surgical skills workshop with Dr. Cesar Augusto Gonzalez Encinales in Bogota, Colombia at the Urologia y Andrologia Hospital Centra Policia Nacional

This surgical skills workshop, directed and produced by Dr. Cesar Augusto Gonzalez Encinales, comprised multiple speakers with expertise in Men’s Health and the surgical treatment of erectile dysfunction as well as the 1st infrapubic implants to be performed in Colombia.  The morning session consisted of a Live Surgery broadcast to roughly 75 physicians from all over the country.  These cases were performed at the Urologia y Andrologia Hospital Centra Policia Nacional on members of the elite Colombia Police force.

The afternoon session consisted of talks on topics related to Men’s Health and surgical treatments for erectile dysfunction including both Infrapubic and Penilescrotal placement techniques, Infection Prevention, Crossover and Urethral Injury Prevention, Treatments for Peyronie’s Disease including the “Scratch” Technique, and Reservoir Placement techniques.

“This may end up being one of the most important meetings of the year for serious implanters if Cesar keeps this up,” said Dr. Perito.

Perito Urology

Dr. Perito’s Commentary on Recent Prostate Cancer Study

Dr. Paul Peritohealth

A recent publication, “Follow-up of Prostatectomy versus Observation for Early Prostate Cancer” (Wilt, TJ, et al), raises the ongoing question regarding patient outcomes during the era of aggressive treatment for prostate cancer and how that compares to “watchful waiting.’ The article does offer exceptional insight into the broad choices facing patients and their physicians, but does not address the psychological toll watchful waiting has on any given patient.

Of course, that toll would also need to be compared to the psychological stressors related to post-operative urinary incontinence and impotence. In addition, if a patient does choose to undergo a prostatectomy, he should be made aware of the manifold treatment options available allowing him to resume a normal life after surgery.

In 2017, no man should suffer from ongoing adverse events relating to the surgical treatment of prostate cancer.