Scrotal incision vertical vs horizontal

The final frontier. Deciding when, if and how.



Donkeykong
Posts: 190
Joined: Thu Aug 08, 2024 4:26 pm

Scrotal incision vertical vs horizontal

Postby Donkeykong » Thu Dec 05, 2024 10:45 am

I see some surgeons make a vertical penoscrotal incision and others horizontal.

Are there advantages of one over the other, e.g. less ischiocavernosus muscle damage (the muscle that flexes your penis) or less scar stricture formation?

newbie443
Posts: 1959
Joined: Fri Dec 01, 2017 9:41 pm
Location: Sedgwick county, Kansas USA

Re: Scrotal incision vertical vs horizontal

Postby newbie443 » Thu Dec 05, 2024 12:32 pm

Donkeykong wrote:I see some surgeons make a vertical penoscrotal incision and others horizontal.

Are there advantages of one over the other, e.g. less ischiocavernosus muscle damage (the muscle that flexes your penis) or less scar stricture formation?


For my original surgery the doctor did a vertical large incision along the seam and even though he removed my scrotal webbing the doctor that did my repair had trouble seeing the scar. The scrotal hides scars very well anyway. The doctor that did my repair used a very small horizonal incision on the left side of midline as he was removing and reinstalling the left cylinder only. That scar is nearly impossible to see. As many of the high-volume implant doctors have a practice name with cosmetic surgery in it, I think the reason is just that. Cosmetic only to hide the evidence of surgery.
Injections failed. Implanted 3-21-18 AMS 700 LGX 21 + 1 RTE 100 cc reservoir 6.5" L 5" G Dr. Kramer.

Proximal Perforation Sling Repair 4/13/21 Dr. Broghammer

67 years young.

Will show and tell and talk with others.

Madecov
Posts: 64
Joined: Tue Sep 03, 2024 10:41 pm
Location: Houston, Texad

Re: Scrotal incision vertical vs horizontal

Postby Madecov » Thu Dec 05, 2024 12:38 pm

My first surgeon did a horizontal incision. The implant was defective and was replaced using the same incision line. I then became infected and the second implant was removed. My final attempt (successful) a different surgeon used a vertical incision
Retired door kicker.

Prostate surgery 1999. Implant July 2023, went bad twice. Third implant June 2024.
Now, Robo Cock in the house.

tomas1
Posts: 2053
Joined: Tue Jul 23, 2013 5:12 pm
Location: Tempe, AZ

Re: Scrotal incision vertical vs horizontal

Postby tomas1 » Thu Dec 05, 2024 2:35 pm

I had the horizontal incision that I estimated was 1" long.
I have no idea if it's visible or not.
I had minimal swelling of the scrotum and that may have been luck or skill on the surgeon's part.
86 years
Inject testosterone weekly.
Implant on 1/22/19 by Dr Avila.
Scrotal, hor. incision just over 1"
18cm AMS 700 CX, 3.5cm RTE 100cc res
Gleason 6 prostate cancer. Monitoring it for now.
Update: On my last biopsies the cancer wasn't found.

jwdetails
Posts: 104
Joined: Thu Oct 12, 2023 4:43 pm

Re: Scrotal incision vertical vs horizontal

Postby jwdetails » Thu Dec 05, 2024 6:47 pm

I had horizontal with my first and second was vertical. I think both healed well, but the only problem with my horizontal one was I think it did cause some more swelling in the scrotum that I didnt experience with the vertical incision. Made it easier to start cycling and use. May also be the surgeon skill/experience more importantly. Cosmetically, both you can't really see once it heals.
62 year old, ED+PD, Coloplast Titan 22 cm no RTE in 2019 with Dr. Irwin Goldstein => failure, now with plaque excision/tunical expansion to Coloplast Titan 26 no RTE in 2022 by Dr. Darshan Patel, now with classic pump 2024 :D

jwdetails
Posts: 104
Joined: Thu Oct 12, 2023 4:43 pm

Re: Scrotal incision vertical vs horizontal

Postby jwdetails » Thu Dec 05, 2024 6:49 pm

jwdetails wrote:I had horizontal with my first and second was vertical. I think both healed well, but the only problem with my horizontal one was I think it did cause some more swelling in the scrotum that I didnt experience with the vertical incision. Made it easier to start cycling and use. May also be the surgeon skill/experience more importantly. Cosmetically, both you can't really see once it heals.


Also my incision vertical was pretty big - almmost half-way up my shaft to allow for the penile scar removal, measured about 4 inches total. All healed in the natural line in the middle like normal.
62 year old, ED+PD, Coloplast Titan 22 cm no RTE in 2019 with Dr. Irwin Goldstein => failure, now with plaque excision/tunical expansion to Coloplast Titan 26 no RTE in 2022 by Dr. Darshan Patel, now with classic pump 2024 :D

Discovernew
Posts: 673
Joined: Sat Jul 08, 2023 5:14 pm

Re: Scrotal incision vertical vs horizontal

Postby Discovernew » Sun Feb 23, 2025 12:48 am

Madecov wrote:My first surgeon did a horizontal incision. The implant was defective and was replaced using the same incision line. I then became infected and the second implant was removed. My final attempt (successful) a different surgeon used a vertical incision


Was the horizontal incision visible?
Implanted October 11, 2024, Dr Karaman. Infla10 AX 20cm +1cm RTE.
My Implant Journal - Click Here

ED about 14 years. Pills worked for 12 years, later worked 50%. Tried almost everything, nothing worked: Shockwave-Testosterone-PRP-Stem Cells-Botox, Etc

JohnHC
Posts: 289
Joined: Mon Apr 24, 2023 9:35 am

Re: Scrotal incision vertical vs horizontal

Postby JohnHC » Sun Feb 23, 2025 7:21 pm

Dr Hakky says a horizontal cut cuts through less nerves. Not sure but from my surgeries not being really painful I'd have to agree with him.
AMS 700 CX 21 cm X 12 mm with 2 cm rear tip extenders. Tenacio pump and 100 ml conceal reservoir done by Dr Hakky on Feb 18th 2025

Discovernew
Posts: 673
Joined: Sat Jul 08, 2023 5:14 pm

Re: Scrotal incision vertical vs horizontal

Postby Discovernew » Tue Feb 25, 2025 10:53 am

JohnHC wrote:Dr Hakky says a horizontal cut cuts through less nerves. Not sure but from my surgeries not being really painful I'd have to agree with him.


did you get a visible scar from the horizontal incision? or it competely went away?
Implanted October 11, 2024, Dr Karaman. Infla10 AX 20cm +1cm RTE.
My Implant Journal - Click Here

ED about 14 years. Pills worked for 12 years, later worked 50%. Tried almost everything, nothing worked: Shockwave-Testosterone-PRP-Stem Cells-Botox, Etc

pjt1958
Posts: 47
Joined: Tue Apr 16, 2024 2:28 pm

Re: Scrotal incision vertical vs horizontal

Postby pjt1958 » Tue Feb 25, 2025 11:29 am

JohnHC wrote:Dr Hakky says a horizontal cut cuts through less nerves. Not sure but from my surgeries not being really painful I'd have to agree with him.


I had a less than 1 inch vertical incision. No issues with numbness or pain afterwards.

I think it depends on the surgeon and where the incision is made, but I think having a small incision (Whether vertical or horizontal) is probably most important to get quick recovery of sensation.
65 with ED for >10 years. Failed pills, not happy with injections. Implanted 6/24/24 (AMS CX 21 cm) with Dr Darshan Patel at UCSD.


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