TY - JOUR
T1 - Subcoronal inflatable penile prosthesis implantation
T2 - indications and outcomes
AU - Feng, Carol L.
AU - Langbo, William A.
AU - Anderson, Lauren K.
AU - Cao, David
AU - Bajic, Petar
AU - Amarasekera, Channa
AU - Wang, Vinson
AU - Levine, Laurence A.
N1 - Publisher Copyright:
© Published by Oxford University Press on behalf of The International Society of Sexual Medicine 2023.
PY - 2023/6/1
Y1 - 2023/6/1
N2 - Background: While implantation of an inflatable penile prosthesis (IPP) is commonly performed via infrapubic or penoscrotal approaches, the subcoronal (SC) approach for IPP implantation may safely and reliably allow for additional reconstructive procedures through a single incision. Aim: The aim of this study is to report outcomes, including complications, of the SC approach and to determine common characteristics of patients undergoing the SC approach. Methods: A retrospective chart review from May 11, 2012, to January 31, 2022, was performed at a single, tertiary care institution to identify patients with IPP implantation via the SC approach. Outcomes: Postoperative information was reviewed and extracted from all clinic notes available following the date of IPP implantation in the electronic medical record, detailing any complications including wound complications, need for revision or removal, device malfunction, and infections. Results: Sixty-six patients had IPP implantation via the SC approach. Median follow-up duration was 29.4 (interquartile range 14.9-50.1) months. One (1.8%) patient had a simple wound complication. Two (3.6%) experienced postoperative infection of the prosthesis, which resulted in explantation of the device. One of these infected prostheses later experienced partial glans necrosis. Revision for mechanical failure or unsatisfactory cosmetic result was performed in 3 (7.3%) IPPs placed via a SC incision. Clinical implications: The SC approach for implantation of IPP is safe and feasible with low complication and revision rates. It offers urologists an alternative to the classic infrapubic and penoscrotal approaches, both of which would require a second incision for additional reconstructive procedures required to adequately address deformities associated with severe Peyronie’s disease. Therefore, urologists who treat these specialized populations of men may benefit from having the SC approach in their array of techniques for IPP implantation. Strengths and limitations: The limitations of this study include its retrospective nature, risk of selection bias, lack of comparison groups, and sample size. This study reports on early experience with the SC approach performed by a single high-volume reconstructive surgeon, who treats a specialized population of patients requiring complex repair during implantation of an IPP, particularly those with Peyronie’s disease. Conclusion: The SC incision for IPP implantation has low rates of complications and remains our approach of choice for IPP implantation in patients with severe Peyronie’s disease, including curvatures >60◦, severe indentation with hinge, and grade 3 calcification, which are unlikely to respond adequately to manual modeling alone.
AB - Background: While implantation of an inflatable penile prosthesis (IPP) is commonly performed via infrapubic or penoscrotal approaches, the subcoronal (SC) approach for IPP implantation may safely and reliably allow for additional reconstructive procedures through a single incision. Aim: The aim of this study is to report outcomes, including complications, of the SC approach and to determine common characteristics of patients undergoing the SC approach. Methods: A retrospective chart review from May 11, 2012, to January 31, 2022, was performed at a single, tertiary care institution to identify patients with IPP implantation via the SC approach. Outcomes: Postoperative information was reviewed and extracted from all clinic notes available following the date of IPP implantation in the electronic medical record, detailing any complications including wound complications, need for revision or removal, device malfunction, and infections. Results: Sixty-six patients had IPP implantation via the SC approach. Median follow-up duration was 29.4 (interquartile range 14.9-50.1) months. One (1.8%) patient had a simple wound complication. Two (3.6%) experienced postoperative infection of the prosthesis, which resulted in explantation of the device. One of these infected prostheses later experienced partial glans necrosis. Revision for mechanical failure or unsatisfactory cosmetic result was performed in 3 (7.3%) IPPs placed via a SC incision. Clinical implications: The SC approach for implantation of IPP is safe and feasible with low complication and revision rates. It offers urologists an alternative to the classic infrapubic and penoscrotal approaches, both of which would require a second incision for additional reconstructive procedures required to adequately address deformities associated with severe Peyronie’s disease. Therefore, urologists who treat these specialized populations of men may benefit from having the SC approach in their array of techniques for IPP implantation. Strengths and limitations: The limitations of this study include its retrospective nature, risk of selection bias, lack of comparison groups, and sample size. This study reports on early experience with the SC approach performed by a single high-volume reconstructive surgeon, who treats a specialized population of patients requiring complex repair during implantation of an IPP, particularly those with Peyronie’s disease. Conclusion: The SC incision for IPP implantation has low rates of complications and remains our approach of choice for IPP implantation in patients with severe Peyronie’s disease, including curvatures >60◦, severe indentation with hinge, and grade 3 calcification, which are unlikely to respond adequately to manual modeling alone.
KW - Peyronie’s disease
KW - erectile dysfunction
KW - inflatable penile prosthesis
KW - reconstruction
KW - subcoronal
UR - http://www.scopus.com/inward/record.url?scp=85160966036&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85160966036&partnerID=8YFLogxK
U2 - 10.1093/jsxmed/qdad049
DO - 10.1093/jsxmed/qdad049
M3 - Article
C2 - 37076135
AN - SCOPUS:85160966036
SN - 1743-6095
VL - 20
SP - 888
EP - 892
JO - Journal of Sexual Medicine
JF - Journal of Sexual Medicine
IS - 6
ER -