V10-10 Fused Double-Cylinder Penile Prosthesis Placement After Phalloplasty Without Urethral Lengthening: A Novel Technique Using a 2-Piece Ipp

You have accessJournal of UrologyLower Tract Reconstruction (Including Transgender) I (V10)1 May 2024V10-10 FUSED DOUBLE-CYLINDER PENILE PROSTHESIS PLACEMENT AFTER PHALLOPLASTY WITHOUT URETHRAL LENGTHENING: A NOVEL TECHNIQUE USING A 2-PIECE IPP Sandeep S. Sandhu, Samhita S. Mallavarapu, Jenna S. Stelmar, Shannon M. Smith, and Maurice M. Garcia Sandeep S. SandhuSandeep S. Sandhu , Samhita S. MallavarapuSamhita S. Mallavarapu , Jenna S. StelmarJenna S. Stelmar , Shannon M. SmithShannon M. Smith , and Maurice M. GarciaMaurice M. Garcia View All Author Informationhttps://doi.org/10.1097/01.JU.0001009392.30237.90.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Transmen (TM) require a penile prosthesis to achieve an erection. All prostheses in the US are designed for cisgender anatomy. There is no recognized gold-standard technique for prosthesis-insertion after phalloplasty. We believe that the ideal IPP to use is the 2-piece IPP (1 or 2 cylinders). We describe 1) Our refined technique for insertion of a 2-piece IPP in transmen post-phalloplasty; 2) Our outcomes over a 6-year period. METHODS: 1) Retrospective chart review of all TM undergoing penile prosthesis insertion after phalloplasty at our center over a 6-year period. 2) We show a VIDEO of our technique for placement of 2-piece AMS Ambicor™ IPP (2-cylinders) for TM post-phalloplasty without urethral lengthening (P-UL). RESULTS: 28 patients underwent 34 implants between April 2017-Oct 2023 (Mean Age=40.8 years±13.8 (SD). 17/28 (60.7%) patients underwent phalloplasty with urethral lengthening (P+UL), and 11/28 (39.3%) had P-UL. All implants were with either the AMS 700™ 3-piece IPP (5/34=14.7%; all 1 cylinder), or AMS Ambicor™ 2-piece IPP (29/34=85.3% [22/29 (76%)=1 cylinder, 7/29 (24%)=2 cylinders). 2/38 IPP's required explant (5.2%): infection: 1/38 (2.6%); wound dehiscence secondary to traumatic injury post-op: 1/38 (2.6%). Our technique for insertion of an Ambicor 2-piece IPP for TM after P-UL. Because the phallus does not contain a full-length neourethra (only a 2-cm. cosmetic neourethra at the tip is present), there is sufficient room to insert 2 cylinders. CONCLUSIONS: Our "2-cylinders in a single sock" technique for transmen post-P-UL has key advantages: 1. Two-cylinders yield a more symmetric-appearing 2. Use of Dacron graft to fuse 3. Our practice of pre-placing a testicle at the planned pump-site ensures a thick capsule-lined pocket to better protect the pump; 4. Patients find IPP deactivation by bending the shaft preferable to using a button on a pump; 5. Our single small 4-cm incision at the scrotum-edge provides adequate exposure with favorable cosmetic results. In our experience with different devices and techniques, the technique described here has the best results. A multi-center outcomes-study to compare devices and techniques, is warranted. Source of Funding: Nil © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e829 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Sandeep S. Sandhu More articles by this author Samhita S. Mallavarapu More articles by this author Jenna S. Stelmar More articles by this author Shannon M. Smith More articles by this author Maurice M. Garcia More articles by this author Expand All Advertisement PDF downloadLoading ...