Penile Implant surgery: Infrapubic or scrotal?

[Bionic Bob]

I had a 18" +3 ams700lgx scrotal approach installed 11 days ago at the University of Kentucky and to date I have zero feeling in either the shaft or glands. It's completely numb. The uro said it may take a little while but feeling should come back. That was 10 days ago and it's improved absolutely none. Can you all make me feel better about this? I too have lost 1.5 inches. I did the VED protocol twice per day for six weeks pre-OP. Also, I've been activating since day 5, it's alot easier on me since I can't feel it. Help!

[jmack858]

Mines was done Infrapubic
My pump was to high, I had my pump moved 8/7/19

[Quincy]

Longer and more complex tubing routing from the peno-scrotal method. Longer scar, harder to heal, causes more trouble in the scrotum, so more bruising and swelling down there.

Infrapubic has less chance of infection, can be done more quickly, and activation and use are typically sooner. I was able to get into hot baths on day 3, activated on day 8, and using it in 3 weeks.

I looked hard at several doctors, was close on choosing peno-scrotal, but made the final decision to do infra-pubic and I'm very glad I did. YMMV.

[tomas1]

Quincy, you have it wrong about longer tubing to the pump.
It's also a straight shot from cylinders to pump.
As far as the incision goes, I don't see a problem with a small scrotum cut.

There may be advantages to penal approach, but not those imo.

[tomas1]

Bionic Bob,
That all doesn't sound good or normal to me.
Did you have penal or scrotal installation?

As far as losing 1.5", that can't be normal or acceptable to me.
Good luck though.

[merrix]

I am nearly ready to select a surgeon for a penile implant. Some prefer an infrapubic (above the penis) incision, and others do a scrotal incision. I have been leaning toward scrotal, since I am worried about damage to essential nerves with the infrapubic approach. However, the infrapubic approach is supposed to heal faster with less pain, so activation can happen sooner, and will leave less tubing in the scrotum.

Does it really matter which way surgery is done? Can anyone provide any guidance in this area?

https://pdfs.semanticscholar.org/e1c1/8 ... a33724.pdf

See "Operative approaches" page 345. According to Dr. Garber, one of the most experienced doctors out there,

Scrotal
+ Excellent access to the corpora, good when patients have fibrosis or peyronies.
+ Excellent access to the scrotum, so pump can be fixed in place.
+ Allows procedure to be done with minimum tissue dissection compared with infrapubic.
+ Allows cylinder insertion with essentially no chance of injury to dorsal penile nerves.
- Requires "blind" reservoir insertion which may be difficult, risky or impossible in patients with prior hernia repair, pelvic surgery or morbid obesity.

Infrapubic
- More tissue dissection and care must be taken to avoid injuring the dorsal penile nerves during cylinder insertion.
+ Allows reservoir insertion under direct vision.

[SW0110]

Scrotal approach here. Very small incision. No pain to speak of. Took half pain pills for couple days. Pump is low and between the boys.

My only issue is deflate button shifted at week 3 to pinting straight out from my body. I actually like it that way. Very easy to use with either hand and since it it titan otr pretty much same diameter all way around so it feels fine this way.

I wanted scrotal method due to prior extensive abdominal surgeries. Also my wife likes hard clitoral stimulation in missionary on her clit in order to orgasm. So however we start she usually finishes like that.

I mentioned that to doc, he said scrotal puts the tubing on the bottom of dick so only thing rubbing her clit will be the top of a really hard dick. Tubing in infrapubic is routed on top so she might have felt tubing. Not sure if that is true just what I was told.

[Greg1956]

I had the scrotal method and my recovery was quick with very little swelling at all. I took one pain pill after I was sent home and the only reason I ok it was thinking it would help me sleep, not due to pain. My incision was larger that a typical scrotal incision because I opted to have scrotal webbing removed during the surgery. The incision was about 2" long, but is pretty much undetectable now.

[lunacynic]

A few things in Dr. Eid's description of the infrapubic approach don't square with some of my own experience and the infrapubic routine practiced by Dr. Kansas.

well, here's MY experience with kansas and infrapubic:

viewtopic.php?t=6743

[andrew1959nj]

I had the scrotal method with a vertical incision. I had very little swelling, some discomfort but no pain. My boys were naturally very sensitive my entire life, limited touch, NO sucking on them. As such, I didn't start inflating until my 4th week post-op.