Prosthetic Urology Excellence: Top Surgeons Share Techniques in 2022 Kickoff Webinar

Dr. Perito initiated the session with a message of unity: while techniques may differ, a meticulously performed penile implant procedure consistently yields high patient satisfaction. He emphasized outcome-driven care over procedural dogma, advocating for collaboration in refining standards across approaches.

“There’s a common ground we can all stand on—regardless of the incision. A well-done implant is a well-done implant.”

Dr. Perito presented compelling data from his high-volume practice, noting that over 80% of patients resume sexual activity within three weeks post-op. He attributed this accelerated recovery to minimal dissection, avoidance of Foley catheters, and targeted use of drains.

Key Benefits:

• Earlier sexual rehabilitation: 82% at 4 weeks; currently trending toward 3 weeks.
• Reduced discomfort: Foley catheters often omitted entirely or removed before the patient wakes.
• Efficient exposure: Achieved within 2–3 minutes using pediatric specula and refined retractors.
• Safer reservoir placement: Closer proximity with less risk using a 70mm nasal speculum.
• Minimal dorsal nerve risk: Thanks to hydrodilatation and precise instrument handling.
• Pump positioning education: Teaching patients to pull the pump down reduces migration.

“I want penile implants to be as accepted as breast implants—routine, accessible, and stigma-free.”

Dr. Carrion highlighted the value of the penoscrotal approach, especially for complex revision surgeries, fibrosis cases, or teaching environments. While this method may involve more vascular exposure, it allows for adjunct procedures and precise pump fixation.

Key Highlights:

• Superior exposure in teaching cases and fibrosis.
• Ease of adjunct procedures like web takedown or vasectomy.
• Pump fixation using anchoring sutures for long-term positioning.
• Adaptability: Allows for longer incisions when anatomical variance demands it.

“It’s not a race. It’s about quality and letting your outcomes speak for themselves.”

After training with Dr. Perito in Miami, Dr. Antonini transitioned from penoscrotal to infrapubic techniques, applying a minimally invasive philosophy. With patients often returning to function faster, his adaptations aim to further improve hemostasis, recovery, and cosmetic outcomes.

Technique Enhancements:

• Two additional sutures on the corpora to prevent hematoma.
• Drain placement for 3–5 days to minimize scrotal swelling and allow early device activation.
• Aesthetic incisions under 2 cm for improved cosmetic recovery.
• Customized “scratch technique” for Peyronie’s disease, correcting curvature while preserving function.

“We aim for less pain, fewer complications, and better recovery. Patients cycle the device within 2 weeks.”

All three surgeons emphasized the importance of:

• High-volume specialized centers for prosthetic urology.
• Structured patient education on expectations, postoperative care, and complications like hypermobility.
• Standardization of technique to improve outcomes globally.

As the field continues to evolve, collaboration between experienced surgeons, tailored training programs, and shared data remain essential to pushing the boundaries of what penile prosthetics can achieve—for both patients and practitioners.