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Hello, could you tell me the advantages and disadvantages of this surgery? Currently, the infrapubic area calls my attention more, I feel that that area will hurt less... I have had many treatments from PRP to Helical Tag to verify leakage and Doppler echo, so that area is already very sensitive.

Lots of different opinions on this. For me personally, I used one of the most high volume doctors in the entire world to do my surgery and he has done probably 8000 at this point, also travels the world to teach the surgery…

He does infrapubic and that’s what I got. Mostly what I’ve read on here is that people have penoscrotal and think that’s a better method…. But for me I trusted my doctor because of his experience and knowledge.

I am 18 days post op now and have almost zero pain (except when cycling and inflating to the max) which is normal and started cycling just over 2 weeks after surgery.

So FOR ME, infrapubic has been wonderful.

The right surgeon FOR YOU is the most important decision. IP or PS is probably lower on the list. You want a high volume doctor with a history of great results. According to Perito, there is no difference between the 2 options after the recovery period.

However, during my research phase I determined that there were a few things that led me to seek an PS approach. Keep in mind, I'm just a guy reading studies, opinions, reviews, statements, etc. This is MY interpretation, others feel the exact opposite.

-A study has shown that the size of the implant is larger when installed penoscrotally. Not much, but larger nonetheless. Seems that access to the corpora for measuring and inflating is better with the PS approach. Watch some youtube videos of both and you might notice the difference,

- Installation of the pump is much more easily done when implanting it directly in the scrotum, which is accomplished by penoscrotal surgery. The doctor can place it exactly where he would like it to live, and you and your partner will appreciate the best placement possible.

- Infrapubic involves a higher risk of damaging the nerves in your penis. The nerve bundle is on the top of the penis and must be manipulated to some degree during the IP surgery. The risk seems to be small, but it is a factor worth being aware of.

-Installation of the reservoir is more difficult when installed through the scrotum, this is a clear advantage of infrapubic installation. My thought process was that I will have interaction on a daily basis with the pump, and I want it placed perfectly in my sac. Hopefully I'll never know or care about the reservoir, and sure enough...I was never sore and I would have no idea where it is in my abdomen had the doctor not pointed to the side it's on.

-Infrapubic will often result in a much quicker release to cycle and use your new penis as intended. Since pumping the cylinders is not stretching out or affecting an incision in your scrotum, men who had IP are often released to start messing around with stuff in days or a couple of weeks. Penoscrotal implantees are usually told to wait 4-6 weeks before cycling or sex. For me, a week here or there to get started didn't outweigh the other advantages I felt penoscrotal offered.

-2 very prolific doctors 100% disagree on which option is best. Eid says that IP is a bad idea and is vocal about it being a mistake, he recommends PS. Perito swears by infrapubic and trains others on how to do them. My PERSONAL opinion is that Perito's preference for IP is tied to the speed at which he can perform the surgery (he claims 15-20 minutes), which in turn allows him to do 4x the ca$e$ as compared to a doctor doing PS and taking about an hour per case (without complications).

-my wife and I enjoy nude resorts now and again, and I didn't want a visible scar showing above my penis. I'm sure it would fade with time, but I don't need all the other guys knowing I'm a cheater..

-of course, if you've had previous surgeries down there or hernia issues, your doctor will know best which option is better for you.

The most important decision is the doctor. In my case, I had a penoscrotal incision and during the measuring phase Dr. Clavell was unable to get the dilator up into my glans on the left side of my penis. He tried smaller dilators but was unable to break through some scar tissue nobody knew was there. On the fly, Dr. Clavell made an incision in my shaft and removed the scar tissue in the corpora and was able to place both cylinders perfectly up into my glans. After the surgery I found a paper that Dr. Clavell was associated with that helped pioneer the very correction I needed. I don't think that had anything to do with PS vs IP access to the glans of my penis, but I'm certain a lesser experienced doctor would not have been ready, able or equipped to perform that additional uncommon surgical correction.

The doctor you choose is the most important factor by a mile.

Here's a link to Dr. Eid's comparison of penoscrotal (left column) and infrapubic (right column) and some answers to questions.
https://www.urologicalcare.com/superior ... technique/

And Dr. Perito explains why he prefers Infrapubic:
https://www.youtube.com/watch?v=CiqI_hKGjHQ
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My doctor used the PS approach and afterward said she was able to get more length using a longer RTE (5 cm). She didn't explain how that was. I'm wondering if the way the tubing comes out of the cylinders would keep the cylinders from going into the groin would limit the positioning going back. So I'm wondering if IP approach would limit going back even more? One poster said PS approach is usually longer.
Apparently IP guys don't have any problem with three tubes coming around the penis instead of one with PS.
Placement of reservoir would be easier IP, but I can't tell where mine is nor did I have any discomfort after surgery.

The debate of ps vs ip will never be resolved.
I watched an ip implant surgery video on YouTube. I didn't like the manipulation of the penis in order to get the 2 measurements. Seemed like it could be easy to make a measuring error bending the penis.
Later I read of the tubing routing issues. I didn't like some of the posted outcomes of that. So I preferred getting a ps surgery.
My selected surgeon only did ps because he wanted the best visibility of the nerve bundle that he could get.
I had 1 rough day around days 3 & 4. I actually took an extra pain pill during that period. But my dr doesn't prescribe a very high dose pills. I've had a stronger dose for a root canal.
First nurses visit was at 1 week. She inspected the wound, deflated me & coached me on inflating. My only trouble was finding the deflate button.
Over the next 3 weeks I had a list to follow. Progressive increases in inflates per day & for longer times. Sex was scheduled for 4 weeks but I'm sure that the timeline could be adjusted if the cycling went differently than projected.
My recovery was about average from others that I've read about. Daily pumping & deflating is easy.
I have 1 tube going around the left side of my shaft. Yes, it can get a little tender but my body seems to be getting used to it. I'm definitely glad that I don't have the multiple tubes that some ps patients report.
I can't report any troubles or disappointments with my surgery. I'm right at 2 months now. The next hurdle is getting my wifes physical health improved.
My experience is the surgery isn't no where as bad as some members fear. Any issues can be resolved by my drs nurse. Time is your friend. What few reasons that may arise to delay your surgery are well worth working diligently to resolve.
Select your dr & his staff carefully.

I've had both. My first was the infrapubic method and my revision was penoscrotal. Actually the healing process was quicker with the penoscrotal method. But the doctor who did my revision did a better job of hiding the pump. It sits right between my balls and it doesn't hang down too low like my first one which was on the right side. And the doctor was able to give me an extra 1/2 inch with this method.

sliphill wrote:I've had both. My first was the infrapubic method and my revision was penoscrotal. Actually the healing process was quicker with the penoscrotal method.

As I understand it, healing process w/ revisions are always easier, regardless of method.

Find a doctor you trust and let them do what they do. Nobody here has more experience than the excellent doctors who have been doing this for years, and yet they still disagree.

There is another one called subcoronal approch

annoyed31 wrote:There is another one called subcoronal approch

Ouch, sounds like the Pez dispenser option.