Everything You Need to Know About Penile Implants

Scrotal Vs. Infrapubic Penile Implant

 

Scrotal Vs. Infrapublic Penile Implant Surgery

Dr. Kramer chooses to do his procedures through a scrotal approach. This has many advantages:

  • Pump placement is more direct.
  • The surgeon has longitudinal access to the cylinders and corpora of the penis.
  • The scar is hidden.

The big advantage to the scrotal approach is that tip placement can be maximized, thus penis length is maximized. The tips can be manipulated and pushed up to maximal dimensions. Also, complex cases and revisions are possible because there is clear access to the corpus cavernosa (erectile body), so more extensive corporal manipulation can be done if necessary.

One downside is that the scrotal procedure can take a few minutes longer as there are more layers to open and close. Reservoir placement can be a bit more difficult scrotally as well, but an experienced surgeon will not have a problem with this technique.

Infrapubic Advantages and Disadvantages

The advantages of this approach may be:

  • Shorter operative time.
  • A cleaner operative field, being away from the scrotum.
  • Since there is not scrotal incision, the pump may be able to be manipulated earlier.

The disadvantages are:

  • The scar is more visible.
  •  The tips may stop far short of the tip of the penis.

With the infrapubic approach the dilator is pushed out through the top or dorsum of the penis with the penis often not on the maximal stretch. Therefore, the tips of the implant may not be brought out to the tip of the penis. Dr. Kramer has revised many penile implants and the most common reason is infrapubically placed devices with tips that are far too short.

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