Abstract Introduction Penile prosthesis (PP) implantation is a surgical technique that currently represents the definitive treatment for erectile dysfunction (ED) in patients who do not respond to medical therapy. The infrapubic approach for PP placement allows direct access to the corpora cavernosa. Although it may involve increased technical complexity, with adequate surgical experience this approach can reduce operative time and eliminates the need for a Scott retractor. It also minimizes the risk of infection by avoiding direct contact with higher-contamination risk areas such as the scrotum, which requires manipulation in the postoperative period. Additionally, it provides improved cosmetic outcomes due to a more discreet incision. In our experience, patients report greater ease in learning pump manipulation in the immediate postoperative period. Currently, at our center, we indicate this approach for primary PP implantation in patients without associated corporoplasties Objective We present the case of a 61-year-old male with a history of insulin-dependent diabetes mellitus and long-standing ED, unresponsive to medical therapy and intracavernosal injections. A Coloplast Titan Touch penile prosthesis (19 cm) was implanted via an infrapubic approach. A 75 mL reservoir was placed through the left external inguinal canal and filled with 65 mL of normal saline. The pump was positioned at the scrotal base. A closed suction (Redon-type) drain was left in place. The postoperative course was favorable, and the patient was discharged within 24 hours. At one-month follow-up, he reported good prosthesis handling and satisfactory sexual activity. Methods Describing the Step and advantages of the infrapubic approach in Penile implant surgery Results As shown. Conclusions Based on our experience, the infrapubic approach for PP implantation is a safe and effective option for the treatment of ED, offering a relatively fast recovery and high patient satisfaction. Disclosure No
Teyrouz et al. (Mon,) studied this question.
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