Ventral phalloplasty

Aim： To present a simple technique during penile prosthesis implantation that promotes the perception of increased phallic length. Methods： The penoscrotal web is defined. A ＂check mark＂ incision is made with excision of scrotal tissue. Excellent exposure is provided for implantation of the cylinders, pump and reservoir. Wound closure is performed longitudinally. Results： This technique is a modified extension of surgeries described in the pediatric literature for webbed penis. Loss of penile length following penile implantation surgery is worrisome for patients suffering from erectile dysfunction （ED）. This technique helps with patient satisfaction, cosmetic results, and improves perception of penile length. Conclusion： Ventral phalloplasty is a safe, technically simple procedure that may be performed in concert with penile prosthesis implantation or as a stand alone procedure under＇certain circumstances.

Implantation of AMS 700 LGX penile prosthesis preserves penile length without the need for penile lengthening procedures

Implantation of an inflatable penile prosthesis （IPP） is a well-established definitive solution for erectile dysfunction when conservative treatments fail. Penile implants may shorten the penis. The AMS 700 LGX IPP is in common use but reports on its mechanical reliability, medium-term postsurgical patient satisfaction, and mean penile length preservation are lacking. We investigate the mean penile length, mechanical reliability, and patient satisfaction at 6 and 12 months after implantation of the AMS 700 LGX. This prospective study consecutively enrolled men undergoing first-time IPP implant surgery from February 2009 to April 2012. Stretched flaccid penile length, penile length at 50% and 100% of stiffness （PSO and P100） and International Index of Erectile Function （IIEF） and Erectile Dysfunction Inventory of Treatment Satisfaction （EDITS） scores, were measured at 6 and 12 months postsurgery. Of 45 patients who underwent AMS 700 LGX implantation （median age 61 years） and completed 6 months＇ follow-up, 36 （80%） completed the study. A significant difference in stretched flaccid penile length was seen between 6 and 12 months （P= 0.033）. P100 was also significantly increased at 6 and 12 months, with a mean 10% increase （1.3 ±0.4 cm） from baseline to 12 months. Differences in mean IIEF scores at 6 and 12 months were significant for the desired domain （P = 0.0001） and for overall satisfaction （P = 0.002）; however, mean EDITS scores at 6 and 12 months were not significantly improved. AMS 700 LGX is a powerful tool for preserving penile length in men undergoing penile prosthesis implantation.

Comparison of the patient and partner satisfaction with 700CX and Titan penile prostheses

Most widespread three-component penile prosthesis models are 700CXTM and Titan~. Our purpose is to assess patient and partner satisfaction after the first implant. This is a multicenter, retrospective, nonrandomized study in which all patients who met the inclusion criteria between 2009 and 2013 were included. In total, 248 patients agreed to participate. To evaluate patient satisfaction, a validated but modified 11-question questionnaire was completed （EDITS）; and a nonvalidated two-item questionnaire was given to the partner. Statistical analysis used an ordinal logistic regression model. Two hundred and forty-eight patients （194 with 700CXTM vs 54 with Titan） and 207 couples completed the questionnaire （165 with 700CXTM vs 42 with Titan）. Overall satisfaction was high. Both showed great reliability for sexual intercourse and high compliance with prior expectations. Most patients were able to manage the penile prosthesis correctly within 6 months. Postoperative penile shortening led to some dissatisfaction in 42% and 46% of cases （700CX/Titan）. Significant differences were found in three questions of patients＇ questionnaire. There were more patients satisfied with the 700CXTM （P= 0.0001）. No patient with Titan implant took longer than 6 months to optimal management. Only 4% of patients with 700CXTM implant were dissatisfied with the deflation, in contrast to 24% with the Titan （P = 0.0031）. Of the two partners＇ questions, one showed a statistically significant difference （P = 0.0026）. It seems that group 700CX＂ would recommend to re-implant the prosthesis with a greater tendency. The overall satisfaction was very high for both prostheses. The final aspect of the erected and flaccid penis was satisfactory, but both groups showed significant discontent with its final size. Partners＇ overall satisfaction was high.

Patient satisfaction and penile morphology changes with postoperative penile rehabilitation 2 years after Coloplast Titan prosthesis

A common complaint after inflatable penile prosthesis surgery is reduced penile length. We previously reported how using the Coloplast Titan inflatable penile prosthesis with aggressive new length measurement technique （NLMT） coupled with postoperative IPP rehabilitation of the implant for 1-year helped to improve patient satisfact on and erectile peni e measurements Th s is a 2 years follow-up of a prospective, three-center, study of 40 patients who underwent Titan prosthesis placement, With new length measurement technique for erectile dysfunction. Patient instructions were to inflate daily for 6 months and then inflate maximally for 1-2 h daily for 6-24 months. Fifteen penile measurements were taken before and immediately after surgery and at follow-up visits. Measurement changes were improved at 24 months as compared to immediately postoperative and at 12 months. 67.8% of subjects were satisfied with their length at 2 years, and 77% had perceived penile length that was longer （30.8%） or the same （46.2%） as prior to the surgery. 64.3% and 17.9% of subjects had increased and unchanged satisfaction, respectively, with penile length as compared to prior to penile implant surgery. All but one subject （96.5%） was satisfied with the overall function of his implant. This study suggests using the Coloplast Titan with aggressive cylinder sizing, and a postoperative penile rehabilitation inflation protocol can optimize patient satisfaction and erectile penile measurements at 2 years postimplant.

Management of residual penile curvature after penile prosthesis placement

Residual penile curvature is a common situation following the implantation of a penile prosthesis in patients with Peyronie’s disease.Currently,there is a variety of options for the correction of residual curvature,including penile modeling,plication techniques,as well as tunical incision/excision with or without grafting.A literature search of PubMed and Medline databases was conducted from 1964 until 2020,using search terms for all articles in the English language.In this article,we provide a review of the techniques and the outcomes,according to the published literature.

Current devices,outcomes,and pain management considerations in penile implant surgery:an updated review of the literature

Penile prosthesis surgery is a definitive treatment for erectile dysfunction(ED).The two categories of penile prosthesis are endorsed by professional guidelines,inflatable penile prosthesis(IPP)and malleable penile prosthesis(MPP).Each modality of penile prosthesis offers distinct advantages and incorporates specific design features,allowing for personalized device selection that aligns with individual needs and preferences.While the overall complication rate of penile implant surgery remains low,surgeons should maintain a high index of suspicion for complications in the perioperative time period.Multimodal analgesic regimens including nerve blocks and narcotic-free pathways should be administered to manage perioperative pain.Finally,the high patient satisfaction after penile prosthesis surgery underscores the success of this ED treatment option.