Abstract
We have developed a new surgical approach for implantation of inflatable penile prostheses, with the aims of earlier use of the device by patients, avoidance of complications of reservoir placement, longer cylinder implantation, and reduced prosthetic infection rates. We have combined two previously described penile implantation techniques from Drs. Eid and Perito, to develop a Minimally Invasive, No-Touch (MINT) penile implant surgical technique. The steps of this procedure include artificial erection with local anesthesia and vaso-dilating medications, small incision and minimal dissection, complete occlusion of patient skin from operative field, and high sub-muscular placement of reservoir, with hernia mesh repair of external inguinal ring at time of reservoir placement. We have prospectively studied 180 consecutive non-selected patients presenting for elective first-time penile implant surgery and analyzed various outcome parameters. All patients have a minimum of three months post-operative follow-up. There are no infections in this group, including diabetic patients. The average implanted cylinder length is 21.11 cms, some 0.95 cm longer than a previous historical series of implants by the same surgeon. 75 % of patients are able to cycle their devices by 4 weeks post-operatively. Four patients required re-operation for pump related issues, and there were no reservoir complications or reservoir herniation. One patient developed penile glandular necrosis requiring urgent explantation.
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