Top ten surgical tricks: infrapubic inflatable penile prothesis implantation

The infrapubic penile prosthesis implantation approach represents a surgical variant to the traditional penoscrotal approach, characterized by a distinctive incision site used to maintain excellent surgical exposure for a penile prosthesis implantation. Its peculiar features include short operative time, minimally invasive nature, low-reported infection rate, and a direct line of sight for reservoir placement; its specific technical challenges include preservation of the dorsal neurovascular bundle, a restricted working space, and a non-negligible learning curve. In the present manuscript, we describe ten surgical tips covering patient selection and positioning, incision placement, fascial dissection, corporotomy and corporal dilation, reservoir dissection and placement, scrotal pump positioning, hemostasis and drain management, intra-operative device testing, tubing routing, and postoperative care. Each tip is supported, where available, by published evidence and is otherwise drawn from surgical experience.