Shaeer Prof. Osama, Shaeer Prof. Kamal

(45) SHAEER’S TECHNIQUE FOR PENILE PROSTHESIS IMPLANTATION THROUGH A SINGLE MIDLINE CORPOROTOMY

  • Urology
  • Reproductive Medicine
  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Psychiatry and Mental health
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Abstract Objectives With the infrapubic approach for penile prosthesis implantation (IPA), lateral corporotomies carry the risk of injury to the laterally-coursing dorsal nerves. This is one of the reasons why IPA is not widely adopted despite its potential advantages. We describe for the first time Shaeer’s IPA; a modification of the infra-Pubic approach, whereby malleable penile prosthesis cylinders are implanted through a single midline corporotomy in the bed of the deep dorsal vein. The midline corporotomy spares the laterally-coursing dorsal nerves. Methods We compared semi-rigid penile prosthesis implantation via the single-midline-corporotomy infrapubic approach (IPA-S, n=11), to the classic infrapubic approach with laterally placed dual corporotomies (IPA-D, n=11) and to the penoscrotal approach (PSA, n=13). Shaeer’s IPA is performed through the infrapubic incision. A 3-5 cm length of the deep dorsal vein is stripped. A single 3-5 cm midline corporotomy is cut along the bed of the vein. Dilation, sizing and implantation are performed through the single corporotomy on either side of the midline septum. Patients are discharged same day, allowed to bend the implant after 2 weeks, and to commence intercourse after three weeks. Results There were no statistically significant differences in age, post-implantation IIEF-5 or satisfaction between the three groups. Average operative time for the IPA-S group was 21.8% shorter than the IPA-D group, and 34.5% shorter than the PSA group. Pain as per the 10-point pain scale was least in the IPA-S group, with a 37.8% difference from the IPA-D group and a 41.9% difference from the PSA group. Those differences were statistically significant. No complications were recorded in the IPA-S group. Infection occurred in one PSA case, and partial hypoesthesia in one IPA-D case. Conclusions “Shaeer’s Single-Midline-Corporotomy Infra-Pubic Approach” is a minimally invasive approach for implantation of the semi-rigid penile prosthesis, avoiding injury of the laterally-coursing dorsal nerves of the penis. Conflicts of Interest None

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