How is penile implant surgery performed? Professor Shaeer performs penile prosthesis implantation surgery in an average of 35-45 minutes. The gentleman is free to leave the hospital the same day, un-assissted, with full erection.
There are several incisions for penile implant surgery. Penile prosthesis can be preformed through the peno-scrotal incision OR the subcoronal incision OR the pubic incision OR the abdominal crease incision.
The subcoronal skin incision for penile prosthesis implantation is made 1-2cm under the glans penis approximately, in a semi-circular fashion. This is most suited for circumcised patients or patients willing to be circumcised, particularly for implantation of a malleable / flexible penile implant. The subcoronal skin incision is cut along the circumcision line so is not stigmatizing or indicative of a penile implant surgery.
The penoscrotal skin incision is performed underneath the penis at its root, next to the scrotum. In fact, it can be more towards the scrotum than it is towards the penis. Therefore it is very much concealed. This incision is suited for all types of penile implants, the semirigid penile implant and the inflatable penile implant.
The pubic skin incision for penile implant surgery is at the base of the penis on the upper (dorsal) surface, at its root from the abdomen. This incision is not very commonly used, with only a handful of experts adopting it. Its adopters report that the infection rate with this approach is the least ever.
The abdominal crease incision for penile prosthesis implantation and penis length enhancement. This is the invention of Prof. Shaeer. This incision is in the abdominal crease, between the abdomen and pubic region. Through this incision, the pubic fat can be removed, pubic skin pulled up to enhance the length of the penis ( penile elongation / penile length enhancement ). The penile prosthesis is implanted through the same incision. The incision is not in the penis so it is the least stigmatizing.
How is penile implant surgery performed ? Steps of penile prosthesis implantation surgery
Time needed: 30 minutes.
How is penile implant surgery performed through the subcoronal incision?
Penile implant surgery can be performed under general or spinal anesthesia. Local anesthesia for penile implant surgery is possible but not recommended by Prof.Shaeer
Penile prosthesis implantation requires scrubbing of the patient’s lower body from umbilicus to knees for 20-30 minutes using alcohol-based media, follows by draping.
- Skin incision
The most commonly used skin incisions are the subcoronal or the penoscrotal incisions.
- The skin and fascia are pulled down to expose the corpora cavernous
The corpora cavernosa are the two erection cylinders along the whole length of the penis where the penile implant will be inserted.
Corporotomies are the incisions to open the corpora cavernosa. They are 1-3 cm in length, and quite superficial , to spare the vascular erectile sinusoidal tissue (cavernous tissue) inside the corpora cavernosa
- Sparing the cavernous tissue
The erectile cavernous tissue inside the corpora cavernosa is set aside to create a space for inserting the penile prosthesis.
The space created inside the corpora cavernosa is dilated by metal dilators all along the length of the penis from the tip towards the glans to bottom adjacent to the pelvis. Serially wider dilators are used to reach maximum width (girth). The length and width of the corpora cavernosa are noted.
- Preparation of the penile prosthesis
The penile implant is prepared according to the length and width of the penis. In case of Coloplast implants, the implant is dipped in sterile fluid containing an antibiotic mixture. The antibiotic will adhere to the body of the implant since Coloplast implants are coated with the ” hydrophilic coat” that does just that.
- Implantation of the penile prosthesis cylinders
A cylinder of the penile implant is inserted in the space created in each of the two corpora cavernosa. Care must be taken to avoid the implant touching the patient’s skin, hence the no touch technique. Gloves are changed with each step, and particularly before this step.
- Insertion of other components of the penile implant
If an inflatable penile implant is being used, the other components can be inserted though the same incision: the pump of the inflatable penile implant into the scrotum, and the reservoir into the abdomen
The corporotomies and the overlying fascial layers are closed in order. Skin is pulled back over the corpora cavernosa and stitched with cosmetic self-absorbable sutures.
- Leaving the hospital after penile implant surgery
Most patients can leave the hospital the same day, on antibiotics and analgesics.
Penile Prosthesis Implantation through the sub-coronal incision
Penile enhancement surgery for restoration of length can be performed in the same setting and through the same incision. Penile Prosthesis Implantation through the peno-scrotal incision, plus elongation and web excision
Sterilization is of utmost importance. Therefore, Professor Shaeer employs the following precautions and additional techniques (among others):
- Full blood sugar control prior to surgery
- Pre-operative and post-operative antibiotics
- Antibiotic-coated implants (upon request)
- Dedicated operation room, exclusive for penile implant surgeries. No other surgeries are allowed-in
- No-touch technique: sterile coverings for the patient’s skin, that prevent any contact between the implant and patient’s skin