Surgical technique

[Steve5231]

I think I’ve seen where some surgeons come through the testicles and others go in from above the penis. Which is better? Quickest/easiest recovery? Or am I totally not understanding the surgical process? Any help much appreciated.

[Gt1956]

I think you understand the two methods.
Its generally accepted that the pubic incision has a slight pain & healing advantage.
Downsides are, many men report feeling the tubing passing around the penis down into the scrotum. Some have reported discomfort during sex with their partner on top. I.E. woman grinding on the pubic bone right where the tubes are. In order to get the tubing to exit the penile shaft high enough. Some surgeons will use more RTE's than might be used during a scrotal incision. RTE's are a necessary item in many cases but it is almost universally accepted that the more RTE'S that are used. The less well the implant is anchored in the cruse. This might lead to less rigidity.
A disscussion should be had with your surgeon. Get his opinion. Research & weigh the points that I've listed. Those problems do not happen every time. I've had that talk with my surgeon. We agree that a scrotal incision is best. Not every surgeon will agree with that conclusion. I'm willing to have a slightly longer recovery, even a bit more pain in order to avoid the chance of those things that I listed.
I do have a little insight into penile surgery. In 2013 I had a circumcision. Several people had warned about the pain & recovery. It wasn't bad in my case. Very few, if any, pain pills were used. To be exact, I drove my truck almost 500 miles after surgery in order to recover in our winter home.
I hope that this helps you. Remember, you're most likely stuck with whatever incision approach that your surgeon wants to do. My second choice doctor almost does pubic only & he is held in fairly high regards here in the USA. Oh, on top of that, hes over 700 miles away & no major airport near him that connects to my area.
Good luck.

[Ronn1708]

I’ve had both types a few times. I like the scrotal approach because the scar is hidden. I have a terrible scar at the base pubic area. Big scar
I always shaved but now am forced to grow hair to cover the hideous scar.

[gjmjoe017]

I had infrapubic and healed very quickly with no problems.No problems with the tubing.I chose this approach and happy I did!

[newbie443]

I think I’ve seen where some surgeons come through the testicles and others go in from above the penis. Which is better? Quickest/easiest recovery? Or am I totally not understanding the surgical process? Any help much appreciated.

Not really a better although some men and doctors like each for a number of reasons. Many say that scrotal has better access and pump placement. And pubic has better reservoir placement. There is also a nerve bundle with pubic that must be avoided but that is really a non-issue with a good doctor. But it is there. And pubic dose have the ability for the man to start cycling a bit earlier as there is less tissue disturbed in the scrotum. You might ask your doctor how long you wait to start cycling with each to see if there is a difference. Some have questioned over the years about infection rates for both and some papers were put out that i saw. Seems there is not a real difference according to the papers. Scaring is an issue with some men. I have had 4 scrotal surgeries and it would take a lot of looking with a magnifying glass to see them. Vasectomy, Hydrocele surgery, implant with scrotoplasty, and implant repair. When I was able to get a doctor to do my repair 3 years after implant with scrotoplasty the doctor had a difficult time finding the old incision. Let alone the prior surgeries to that. But pubic scars are more visible if you shave as was noted. The tubing can be another issue. It is there with both and can be felt. And this may be uncomfortable with some men with pubic. But some men have posted the same with scrotal. This could be just rare occurrences or be more to do with doctor skill or even with an underlying condition. Not sure the answer here. The fact is though that the tubing exits the top of the penis with pubic and the bottom with scrotal. As far as RTE's I cannot remember reading anything that indicated difference in approach made a difference. The AMS surgical guide stated if the proximal corpora could not be dilated enough for the tubing to go down in the corpora to measure differently so the tubing connection to the cylinder would line up with the incision in the corpora. Some doctors may just like to use RTE's. But the well known ones I have check with try to use as little as possible. This is just my understanding and there may be more to this than I have read.

All my scrotal surgeries were not very painful. At least not compared to others I have had. All were controlled with over the counter pain meds. Of course others do have more pain with this depending on the doctor and the amount of work that was done. I can understand how cycling in the beginning would have been easier and more comfortable though.

To me there is no clear cut one is better. I would say to find the best doctor you can and go with what that doctor dose best. If you are able to go to different really good doctors then you can talk with them about your concerns if any and decide on which you want to have.

Good luck.