Ricerc@Sapienza

Background: The 3-piece inflatable penile prosthesis (IPP) is the gold standard treatment for male erectile dysfunction when other less invasive approaches are contra-indicated or unacceptable for the patient. There are currently 2 surgical approaches for IPP implantation: the penoscrotal (PS) and the infrapubic (IP) incision.
Aim: To assess the most recent evidence on the impact of surgical approach for 3-piece IPP implantation in patients with erectile dysfunction.

Peyronie's disease is a devastating condition resulting in penile malformation, erectile dysfunction, pain and emotional distress. In this prospective, 2 institution study we evaluated a multimodal surgical and mechanical combined approach to the definitive treatment of Peyronie's disease and concomitant erectile dysfunction. Materials and Methods: A total of 145 select patients underwent endocavernous disruption of Peyronie’s disease plaques via the scratch technique, followed by inflatable penile prosthesis insertion.

Background: Unidentified distal crossovers, delayed distal crossovers, and impending lateral extrusion are complications
of penile prosthesis implant insertion but are not as common as prosthesis infection or mechanical failure.
Aim: To evaluate results of a surgical technique, the distal corporal anchoring stitch, that addresses fixation of the
penile prosthesis in patients with these complications.
Methods: A lateral sub-coronal incision is used on the side where the crossover or laterally extruding cylinder

Objective: Penile prosthesis implantation (PPI) represents the gold standard
treatment for erectile dysfunction when conservative approaches (oral PDE-5
inhibitors, transurethral suppositories or prostaglandin injections) fail.
Although many studies about PPI have been published so far, data about
psychosexual dimensions and attitudes towards sexuality are lacking. The
aim of this study was to analyse the factors involved in sexual function and
sexual satisfaction in patients undergoing inflatable penile prosthesis
implantation.

In this invited article, we briefly review the history of the penile prosthesis and the various surgical approaches that have been described. With intra-operative photos and illustrations, we discuss Dr. Perito's infrapubic surgical approach. We also highlight the patient selection, post-operative care and complications.