Penile Prosthetic Surgery

Practical Guide to Prosthetic Implant

1st Edition - November 9, 2024
Imprint: Academic Press
Editors: Andrea Cocci, Marco Capece, Marco Falcone
Language: English
Paperback ISBN:
9 7 8 - 0 - 4 4 3 - 1 5 2 4 3 - 6
eBook ISBN:
9 7 8 - 0 - 4 4 3 - 1 5 2 4 4 - 3

Penile Prosthetic Surgery provides comprehensive coverage of penile prosthesis surgery. The book thoroughly describes the different types of penile prosthesis and provides… Read more

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Penile Prosthetic Surgery provides comprehensive coverage of penile prosthesis surgery. The book thoroughly describes the different types of penile prosthesis and provides step-by-step surgical procedures in diverse patients. Additionally, access to supplemental videos to accompany the procedures provide enhanced learning through the opportunity to see procedures carried out. Content covers the common tips and tricks for successful surgery and presents possible complications with accompanying solutions.

Coverage includes full acknowledgement and examinational of the basic research and underling pathological mechanisms that are present in the erectile dysfunction resistant to medical therapy as well as the counselling that patients may need from both the urological and psychological point of view. The book gives a full comprehension of penile prosthesis surgery from multiple viewpoints making it the perfect reference for urologists, andrologists and psychologists.

Penile Prosthetic Surgery
Cover image
Title page
Table of Contents
Copyright
Surgical video playlist
Contributors
Chapter 1 Introduction
Chapter 2 The etiology of erectile dysfunction
Abstract
Keywords
Psychogenic ED
Neurogenic ED
Vascular ED—Arterial disorders
Vascular ED—Cavernous venous-occlusive dysfunction
Metabolic disorders and ED
Diabetes mellitus
Hormonal related ED
Drug-related ED
Antihypertensive agents
Aldosterone receptor antagonists
Thiazide-type diuretics
β-Adrenergic blockers
Angiotensin receptor blockers
Antidepressants drugs
Antipsychotics
Antiandrogens
Andrological urgencies and ED
Penile trauma
Priapism
References
Chapter 3 Clinical indications for penile prosthesis implantation
Abstract
Keywords
Introduction
Indications to penile prosthesis surgery
Penile prostheses revision/re-implantation
Penile prosthesis model: How to choose?
Malleable penile prosthesis
Two-piece inflatable penile prosthesis
Three-piece inflatable penile prosthesis
Discussion and conclusion
References
Chapter 4 Anatomy: What we need to know
Abstract
Keywords
Penile urethra
Nerves
Vessels
Lymphatic drainage
Scrotum
Inguinal canal and lower abdominal wall
References
Chapter 5 Psychosexual counseling in patients attending penile prosthesis implants
Abstract
Keywords
Psychological, sexual, and relational issues in patients with chronic erectile dysfunction
The role of the psychosexologist
Preoperative psychosexual counseling
The vacuum device
The role of the partner
Couple sessions
Postoperative psychosexual counseling
Conclusion
References
Chapter 6 Preoperative exams and informed consent
Abstract
Keywords
Introduction
Preoperative exams
Medical history and physical examinations
Drug history
Fasting blood glucose and HbA1c
Culture tests
Urological assessment
Other exams
Informed consent
Definition and general characteristics
Example of informed consent for penile prosthesis implantation
Conclusion
References
Chapter 7 Counseling, physical, and medical preparation to the penile implant
Abstract
Keywords
Introduction
Selection of the patient
Medical history correlated to penile implant surgery
Previous abdominal surgery
Use of antiplatelet and anticoagulant and optimization
Diabetes and HbA1c optimization, use of steroid, and spinal cord injury patients
Preoperative counseling
Informed consent
Infection
Preoperative optimization
Penile length optimization
Preoperative prophylaxis with antibiotics
Urinalysis and culture
Preoperative skin disinfection
Removal of the hair
Operative considerations
Intraoperative antibiotics
Preparation of the skin
“No-touch” technique
Prosthesis reliability
Damage to closer anatomical structures
Explant of the prosthesis
Expectations management
Postoperative satisfaction
Sensitivity erogenous sensations and penile length
Partner’s satisfaction
Conclusions
References
Chapter 8 History of penile prosthesis
Abstract
Keywords
Before 1974
Acrylic implants
Silicone implants
Polyethylene rods and intracavernosal placement of the prosthesis
1974: New era in penile implant surgery
Three-piece inflatable PP
Single-piece inflatable PP
Two-piece inflatable PP
Latest technological improvements
Parylene coating
Pump
Cylinders
Reservoir
Antiinfective coating
Transgender
Conclusion
References
Chapter 9 Types of penile prosthesis available
Abstract
Keywords
Introduction
Malleable or semi-rigid prostheses
Inflatable or hydraulic penile prostheses
Two-piece prosthesis
Three-piece prosthesis
Choosing the best type of prosthesis for the patient
Comparison of inflatable prostheses
Prosthesis for FTM assignation surgery
Final reflection and conclusion
References
Chapter 10 Semirigid penile prosthesis implantation
Abstract
Keywords
Introduction
Preparation
Surgical technique
Penoscrotal approach
Infrapubic approach
Postoperative care
Complications
References
Chapter 11 Step-by-step bicomponent inflatable prosthesis implant
Abstract
Keywords
Device description
Device function: Inflation
Device function: Deflation
Contraindications
Preoperative setting
Step-by-step operational instructions
Preparation of the patient
Procedural instructions
Topographic anatomy
Topographic anatomy
Topographic anatomy
Implant the cylinders
Implant the pump
Postprocedure information
Immediately postoperative
After the patient is released from the hospital
References
Chapter 12 Infrapubic surgical approach for implantation of three-piece hydraulic penile prosthesis
Abstract
Keywords
Chapter 13 Step-by-step three-piece inflatable prosthesis scrotal approach implant
Abstract
Keywords
Background
Procedure description
General considerations
Patient positioning, shaving and scrubbing
Surgical field preparation and incision
Cavernotomy
Dilation
Measuring the corpora cavernosa
Device preparation
Cylinders insertion
Pump placement
Reservoir placement
Connecting the tubes
Incision closure and drainage?
References
Chapter 14 Step-by-step double implantation of penile prosthesis and male sling or mini-jupette for urinary incontinence
Abstract
Keywords
Introduction
Preoperative workup and patient selection
Step-by-step manual of IPP placement with mini-jupette
Preparation
Material
Procedure
Step-by-step manual of IPP placement with male sling
Preparation
Material
Procedure
Postoperative care
At the hospital
At home
Usage of the IPP
Functional results
Combined implant with mini-jupette
Combined implant with male sling
Complications
Combined implant with mini-jupette
Combined implant with male sling
Future perspectives
Scientific research
Financial considerations
Conclusions
References
Chapter 15 Step-by-step double implantation of penile prothesis and urinary sphincter
Abstract
Keywords
Introduction
Devices’ components and placement
AUS
Penile prosthesis
Step-by-step surgical technique dual implantation
Synchronous dual implantation
Sequential dual implantation
References
Chapter 16 The use of TachoSil to correct residual curvature during inflatable penile prosthesis implantation: The PICS technique
Abstract
Keywords
Introduction
Surgical procedure: The PICS technique
Conclusions
References
Chapter 17 Transgender neophallus implant
Abstract
Keywords
Introduction
History and different kinds of existing prosthesis
Surgical technique
Surgical timing
Preoperative antibiotics
Description of inflatable prosthesis implant surgical technique
Results
Satisfaction report in literature
Complication report
Conclusions
References
Chapter 18 Step-by-step implant in Peyronie’s disease
Abstract
Keywords
Preoperative assessment
Intraoperative assessment
Addressing the penile deformity and correction/reconstruction of the cavernosal bodies
Inserting the penile prosthesis
Postoperative care
Chapter 19 Enhancing size and function with nongrafting tunica expansion
Abstract
Keywords
Introduction
The TEP nongrafting strategy in seven steps
Step 1. Accessing the corpora
Step 2. Dissecting the NVB without urethral detachment
Step 3. Using mathematical formulas for tissue expansion
Step 4. Intraoperative selection of cylinder size
Step 5. Preventing buckling with biomechanical solutions
Step 6. Refining penile geometry with TEP
Step 7. Optimization of axial rigidity
Postoperative management and follow-up
Glans ischemia prevention [38]
Summary of the TEP strategy for penile prosthesis implantations
References
Chapter 20 Step-by-step plaque incision with patch grafting and inflatable penile implant via subcoronal incision for Peyronie’s disease
Abstract
Keywords
Introduction
Indications for IPP with PIG
Surgical risk
Preoperative workup
Advantages of the surgical technique
Alternatives
Clinical case presentation
Surgical procedure
References
Chapter 21 Step-by-step implant in severe fibrosis
Abstract
Keywords
Introduction
Surgical strategies
Cavernotomes
Other technical options
Which device should be used in patients with corpora fibrosis?
Is the cosmetic result the same as in first implantation?
Can we make suggestions?
Conclusions
References
Chapter 22 Step-by-step penile prosthesis implant postpriapism
Abstract
Keywords
Introduction
Conservative treatment
Early penile prosthesis implantation
Step by step
Delayed penile prosthesis implant postpriapism
Step-by-step procedure
Conclusion
References
Chapter 23 Step-by-step penile implant with cosmetic surgery for short penis
Abstract
Keywords
Background
PP placement techniques that maximize corporal length
Cavernosal sparing and channeling without dilatation
Subcoronal incision with circumferential penile degloving
Concurrent PP implant and corpora cavernosa lengthening
Circumferential incision
Sliding technique
MoST
MUST
Techniques that improve perceived penile length when implanting a PP
Ventral phalloplasty
Suprapubic lipectomy and liposuction
Suspensory ligament release
Conclusions
References
Chapter 24 Treatment of penile prosthesis implant infections
Abstract
Keywords
References
Chapter 25 The management of noninfectious complications of penile prosthesis implantation
Abstract
Keywords
Introduction
Intraoperative
Corporal cross-over or perforation - proximal or distal
Urethral injury
Reservoir complications - bladder/vascular/intraperitoneal/superficial
Device injury
Perioperative
Hematoma
Severe pain
Glans ischemia
Urinary retention
Long-term complications
Erosion
Pump problems
Glans problems - floppy glans, cold glans
Mechanical failure
Autoinflation
Summary
References
Chapter 26 Management of the dissatisfied patient
Abstract
Keywords
Penile prosthetic surgery and satisfaction
Biopsychosocial factors predicting dissatisfaction
Managing the dissatisfied patient
Limitations and final remarks
References
Chapter 27 Ongoing research future of the penile implant
Abstract
Keywords
Introduction
Improvement of IPP cosmetic surgery
Preservation of penile girth and length: Patient expectations
Combined treatment
Ectopic reservoir placement
Inflatable penile prosthesis innovations
Infections management
Complications management
References
Index

Andrea Cocci

Dr. Andrea Cocci, PhD is a specialist in Urology and Andrology in Calenzano (Fi), Italy. He is a member of the Sexual and Reproductive Health Guidelines Panel, coordinator of the Uro-Facilities group of the SIU (Society of Urology) as well as member of the Web Committee of the Italian Society of Andrology. He has participated in 8 clinical studies spanning prostatis to clock studies and has experience with endoscopic, robotic and open urological surgery.

Affiliations and expertise

Assistant Professor of Urology, University Florence, Florence, Italy

Marco Capece

Dr. Marco is an Assistant Professor of Urology and Research Fellow in the Department of Neuroscience and Reproductive and Odontostomatological Sciences at the University of Naples. He has always been involved in Andrology and Reconstructive Surgery of the male genital system, from the beginning of his course of studies in Medicine and Surgery. He has experience with Male Infertility and Erectile Dysfunction, basic research on Peyronie's disease, and the development of microsurgical skills - for both male infertility and reconstructive treatment - as well as plaque and prosthetic surgery techniques. He continues research of reconstructive plastic surgery techniques of the male genital system, urethral pathologies and complex urethral surgery as well as medical and surgical treatment of erectile dysfunction, Peyronie's disease, neoplasms of the urogenital system and male infertility.

Affiliations and expertise

Department of Urology, Mediterranea Hospital, Naples Department of Urology and Andrology, Malzoni Research Hospital, Avellino

Marco Falcone

Dr. Marco Falcone is a urology consultant at the neuro-urology clinic in Torino and the urology clinic at the University of Turin. He is a member of the SIA (Societa Italiana di Andrologia), ESSM (European Society of Sexual Medicine), SIU (Società Italiana di Urologia), and the EAU (European Association Urology). He serves as a journal board reviewer for multiple journals including European Urology, Asian journal of Andrology, The Journal of Sexual Medicine, and the International Journal of Impotence Research.

Affiliations and expertise

SC Urologia U - Molinette hospital SC Neurourologia - USU/CTO hospital AOU “Città della Salute e della Scienza”, University of Turin - Italy Urology dpt, Medical Faculty, Biruni University

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Penile Prosthetic Surgery

Practical Guide to Prosthetic Implant

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Andrea Cocci

Marco Capece

Marco Falcone

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