Outcomes and patient satisfaction after Penuma silicone implant surgery via two surgical approaches

The Penuma is a soft silicone penile implant designed for cosmetic enhancement of the flaccid penis in men who have normal erections.

The goal of this study is to report outcomes on patient satisfaction at least 6 months after Penuma subcutaneous penile implant for cosmetic enhancement of the penis, and to determine if modifications in surgical approach resulted in reduction in postoperative complications.

Penile measurements, adverse events, and patient satisfaction were compared between patients undergoing the new lateral scrotal incision versus the traditional infrapubic approach.

A retrospective chart review was performed on all patients who underwent a Penuma implant by a single surgeon from April 2019 to December 2022. A 26-item non-validated device-specific questionnaire was sent to patients at least 6 months after the date of their initial surgery.

A total of 92 cases were performed by a single surgeon. The average increase in flaccid length was 2.5 cm (±2.2), representing a 44% increase (p < 0.01). The average increase in girth was 3.1 cm (±1.8 cm), a 32% change (p < 0.01). Seroma requiring drainage occurred in 12%. 7% of patients required operative revision of the implant. When assessed by surgical approach, the revision rate was significantly higher in infrapubic patients (13% vs 2%, p < 0.05). The implant removal rate was also significantly higher when the infrapubic approach was used (21% vs 6%, p < 0.05). 82% of patients reported being satisfied or very satisfied with their postoperative penile appearance. 75% of patients would undergo surgery again.

The subcutaneous Penuma penile implant appears to improve satisfaction with regard to the appearance of the penis and is a viable option for men who desire to enhance flaccid penile length and girth. Furthermore, the lateral scrotal surgical approach appears to have a lower postoperative complication rate.