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I had infrapubic incision. Many folks have scrotal incision. I did not have much swelling but did have pain along my shaft, but dr had me pumped up about 80%. no incision in scrotum so handling pump is not painful. The tubes come up from the pump, around the left side my dick then into the top. The reservoir tube feels like it runs from the pump around the right side my dick into the reservoir. ? With the scrotal incision do the tubes run from the pump and right into the bottom of your penis? What are the pros and cons of both procedures?

One unarguable advantage is no visible scar with a verticle scrotal incision right on the natural seam line of the scrotum.

Also, those that use the scrotal approach argue the tubes are kept away from the penis shaft and less visible. They might also mention that the pump can be more easily mounted high and to the rear of the testicles where it is less visible.

I have also heard something about maintaining size or sizing. Did your infrapubic approach require an incision on the penis below the glans?

From what I have read some doctors prefer one over the other. I have also read that penoscrotal is best for pump placement and infrapubic is best for reservoir placement. I have also read that with infrapubic that there are nerves that can be damaged and it is an added risk. And as mentioned the scar. And previous surgeries may require one or the other.

From my own observations with my penoscrotal surgery the tubes to the cylinders do go in from the bottom. My surgeon likes long tubing and I knew about that before hand so there is tubing that does loop up in the upper part of my scrotal sack and bottom part of my shaft. I knew about this and do not mind I just wanted it to work again and as much size back as I could get. The reservoir caused me discomfort for a little over 6 weeks and is just now beginning to most of the time not be noticeable. I had a previous abdominal injury and surgery so this may have something to do with that. The incision is mostly healed and will soon be completely gone.

If you would like to see this there is a link in my signature for a video of my surgery that shows the tubing.

Take care I hope this answer's some of your questions.

I had a horizontal incision across the "face" of my scrotum, so to speak. The pump is to the left of and above both testicles (from my point of view ha ha). It was explained to me that this is standard procedure at the VA hospital where I go. The pump is oriented more sideways than down or up, with the tubes crossing under my penis and over my testicles to the pump. I've noticed that while riding on my motorcycle I need to consider my seating position, as that left testicle can get squeezed up against the pump with this orientation. Otherwise I like it and the pump is very easy to reach and work

Strange report. No mention whatsoever about the change in tube routing or pump placement and no mention visible signs of scar suggest implant surgery.

Although I am far from completely informed on this topic, here is Dr. Eid's assessment. It seems he suggests the need for an additional incision in the penis with the infra-pubic approach unless I misread this.
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Surgical approach - Dr Eid
Performing the surgery through a midline scrotal incision will not only result in a better cosmetic outcome
(scar will be concealed by the natural raphe) but also will maximize length. Making a transverse incision above the
penis or below the penis will result in a more distal (closer to the glans penis) incision onto the shaft of the penis often
beyond the body plane or bodyline. Input cylinder tubes that exit the penis and connect the cylinders to the pump
are more likely to be visible and palpable by the patient and partner. Scar tissue will also form on the part of the penis
that is supposed to stretch with an erection decreasing the overall length of the erect penis. Regarding the "above the
penis" surgical approach, tubing from the cylinders will exit the base of the shaft at the 12 o'clock position and
make a 180 degree turn to reach the scrotal pump. This tubing will therefore be palpable at the base of the lateral
aspect of the shaft of the penis on the right, may rub and be painful during intercourse and even limit the depth of
penetration. This can be particularly annoying for the thin patient.

Hawkman wrote:Although I am far from completely informed on this topic, here is Dr. Eid's assessment. It seems he suggests the need for an additional incision in the penis with the infra-pubic approach unless I misread this.
_____________________________________________________________________________________________________________________________________________

Surgical approach - Dr Eid
Performing the surgery through a midline scrotal incision will not only result in a better cosmetic outcome
(scar will be concealed by the natural raphe) but also will maximize length. Making a transverse incision above the
penis or below the penis will result in a more distal (closer to the glans penis) incision onto the shaft of the penis often
beyond the body plane or bodyline. Input cylinder tubes that exit the penis and connect the cylinders to the pump
are more likely to be visible and palpable by the patient and partner. Scar tissue will also form on the part of the penis
that is supposed to stretch with an erection decreasing the overall length of the erect penis. Regarding the "above the
penis" surgical approach, tubing from the cylinders will exit the base of the shaft at the 12 o'clock position and
make a 180 degree turn to reach the scrotal pump. This tubing will therefore be palpable at the base of the lateral
aspect of the shaft of the penis on the right, may rub and be painful during intercourse and even limit the depth of
penetration. This can be particularly annoying for the thin patient.

All of above is mostly true in my case with infrapubic. It did heal quick. The small vertical scar is up on my pubic pad and does not impact my penis stretching. returned to painless intercoarse at 4 weeks.

Well, there is a third type of incision. Have you considered it?

Well, there is a third type of incision. Have you considered it? It is called a subcoronal approach.