(187) The SAPOC Technique: Slices Around Point of Maximal Curvature at Time of IPP placement in Severe Peyronie's Disease

Abstract

Abstract Introduction Placement of an inflatable penile prosthesis (IPP) is indicated for patients with severe Peyronie's disease and erectile dysfunction (ED). Most cases involving plaque incision and graft placement are performed at the point of maximal curvature which result in a large defect that requires placement of a large graft while postoperative penile shortening remains a significant concern among patients. Objective To present a video of a novel modification of the multiple slit technique (MUST) for the treatment of severe PD and ED during IPP placement. This technique involves multiple relaxing incisions made around the point of maximal curvature (POMC) which minimizes the size or even the need of a graft while allowing for length restoration. Methods This technique involves elevation of the neurovascular bundle for dorsal or lateral curvatures along with elevation of the urethra for ventral curvatures. After the POMC is identified, 2 to 4 transverse relaxing incisions (slices) are made around the POMC approximately 1 to 1.5cm apart in order to minimize the size of the defect and hence the need or size of the graft. Each slice allows for maximal restoration of length. Results The SAPOC technique results in correction of curvature and length restoration. Conclusions The SAPOC technique at the time of IPP placement is a novel, safe and feasible technique for the management of complex PD and ED. This technique allows the surgeon to complete the procedure without graft placement in some occasions which theoretically will decrease operative time. It also provides for length restoration which will increase patient satisfaction. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Consultant for Boston Scientific and Coloplast.