Comparison of Infrapubic vs Penoscrotal Approaches for 3-Piece Inflatable Penile Prosthesis Placement: Do We Have a Winner?

Palmisano, Franco; Boeri, Luca; Cristini, C.; Antonini, Gabriele; Spinelli, Matteo; Franco, Giorgio; Longo, Fabrizio; Gadda, Franco; Colombo, Fulvio; Montanari, Emanuele

doi:10.1016/j.sxmr.2018.03.007

Cited by 50 publications

(13 citation statements)

References 31 publications

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“…The study did not reveal any statistical significance with a 2.9% infection rate in 139 infrapubic implants versus a 0.9% infection rate in 221 peno-scrotal implants (P=0.15). (39) A large systematic review published in 2018 reviewed 22 studies comparing infection rates between 3-piece penoscrotal IPP insertion versus 3-piece infrapubic insertion and concluded no evidence that surgical incision strategy reduces infection risk (40).…”

Section: Surgical Approach and "No-touch" Techniquementioning

confidence: 99%

Penile implant infection factors: a contemporary narrative review of literature

2021

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We aim to review and summarize published literature that features implanted penile devices and details infection of these devices as a complication. In particular, we will detail the factors that influence infection of penile implants.Background: Types of penile prostheses include inflatable implants and semirigid implants; these are utilized for treatment of erectile dysfunction. Likely the most feared complication of penile implants is infection. There are a handful of factors that are implicated in device infection.Methods: Searches were performed using MEDLINE and PubMed databases using keywords and phrases 'penile implant AND infection'; 'penile prosthesis AND infection'; 'penile implant infection'. We have presented results from our literature search. We divided these into 'Surgical Elements' and 'Patient Selection and Factors.' Each topic is discussed in its own section. Conclusions:Strides have been made since the initial penile prosthesis surgeries to improve infection rates including diabetes control, antibiotic coating of devices, and antibiotic implementation. Going forward, more studies, especially randomized control trials, need to focus on defining levels of diabetic control (sugar control and A1C control), determining the role of metabolic syndrome in infection promotion and determining laboratory values which could be predictive of infection. We present a discussion of important factors to consider in the realm of penile prosthesis infections. In addition, we include studies which discuss topics for future directions in decreasing the number of infections seen with penile prostheses.

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Section: Surgical Approach and "No-touch" Techniquementioning

confidence: 99%

Penile implant infection factors: a contemporary narrative review of literature

2021

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“…Additional PD management strategies were developed after the re-proposed infrapubic approach in three-piece inflatable penile prosthesis placement, described by Perito in 2008. 47 Although this technique has proven to be comparable to the classic penoscrotal incision in terms of patient safety and satisfaction, 48 an undeniable disadvantage is the impossibility of directly manipulating the fibrotic plaques.…”

Section: Current Aspects and Future Perspectivesmentioning

confidence: 99%

The evolution in the surgical management of Peyronie’s disease

et al. 2021

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Peyronie’s disease (PD) is due to a fibrotic alteration of the tunica albuginea of the penis. It is responsible of penile pain, angulation, and possible erectile dysfunction (ED). Despite almost three centuries have passed since the first description of the disease, etiology still remains uncertain. This fact has led to the lack of a truly effective medical therapy and to date the surgical treatment, although not yet standardized, is the only one that offers acceptable outcomes in terms of function and overall patient’s satisfaction. Since the beginning of the surgical experience in this field, two different currents of thought have developed: the first, involved the proposal of a number of different plication techniques, applied on the healthy side of the penis, opposite to the sick side, with the sole purpose of correcting the curvature; on the other side, efforts have focused on treating the “focus” of the disease, thus developing the so called “plaque surgery.” If with the passing of the decades neither of the two “philosophical” currents has prevailed, this probably depends on the fact that is still not clear which is the lesser of evils: the frequent onset of ED which may follows the plaque surgery or rather the penis shortening that inevitably occurs if any technique of plication has been applied. Our contribution aims to offer an historical retrospective of the surgical treatment of this disease as well as to discuss the latest international guidelines on this topic. The reader will also find some notes about our personal experience in this field.

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“…35 Decreased glans sensation remains a theoretical risk with an infrapubic approach or surgical correction of glans hypermobility, but reported rates of this are low. 22,32 Glans ischemia is a rare complication associated with cardiovascular disease, poorly controlled diabetes, smoking, radiation, and prior prosthesis, and is thought to be related to disruption of glanular blood supply via the dorsal penile arteries and corpus spongiosum muscle. Risk of this complication can be minimized by avoiding subcoronal incisions, concomitant circumcision or penile degloving in high-risk patients.…”

Section: Complications: Type and Preventionmentioning

confidence: 99%

“…The penoscrotal approach remains the most common and there is currently no evidence to suggest that the surgical approach changes the infection risk. 22 The implant should be placed using a 'no touch' technique, in which the surgeon minimizes contact with the patient's skin. Traditionally the 'no touch' technique starts with making a penoscrotal incision, exposure is obtained, and the retractor placed.…”

Section: Infectionsmentioning

confidence: 99%

An update on the best approaches to prevent complications in penile prosthesis recipients

Krzastek

Smith

2019

Therapeutic Advances in Urology

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Placement of inflatable penile prosthesis is a procedure frequently performed for medication-refractory erectile dysfunction. Device implantation is not without risks, and as the frequency of device implantation increases, so do associated complications. The aim of this work is to review the most frequent operative complications associated with implantation of inflatable penile prostheses, and to review the best approaches to prevent these most common complications. Complications can broadly be categorized as infectious, noninfectious tissue-related, device-related, or related to patient and partner satisfaction. With understanding of these complications and ways to avoid them, as well as with appropriate patient selection and counseling, the inflatable penile prosthesis is an excellent option for the treatment of erectile dysfunction.

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Comparison of Infrapubic vs Penoscrotal Approaches for 3-Piece Inflatable Penile Prosthesis Placement: Do We Have a Winner?

Cited by 50 publications

References 31 publications

Penile implant infection factors: a contemporary narrative review of literature

Penile implant infection factors: a contemporary narrative review of literature

The evolution in the surgical management of Peyronie’s disease

An update on the best approaches to prevent complications in penile prosthesis recipients

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