Infra pubic or infra scrotal?

The final frontier. Deciding when, if and how.

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oldbeek
Posts: 245
Joined: Sun Sep 10, 2017 1:46 pm
Location: Los Angeles area

Infra pubic or infra scrotal?

Postby oldbeek » Mon Feb 12, 2018 1:41 am

What are the advantages of intra scrotal or intra pubic procedures?
76 good health, RP 7-2017, Cancer outside prostate all nerves taken , 10 months post RP, PSA 0.05, Pain with trimix, implant at USC Keck , DR Boyd on 4-18, Infra-pubic, AMS lgx 15 cm with 5cm rte

jackhammerdreamz
Posts: 256
Joined: Sat Sep 09, 2017 9:38 pm

Re: Infra pubic or infra scrotal?

Postby jackhammerdreamz » Mon Feb 12, 2018 3:14 am

I've heard with infra-pubic they can more easily place the reservoir, the negative is if the surgeon isn't precise and skillful they can cut precious vessels that affect nerves causing less pleasure sensitivity post op.
Peno-scrotal is easier to "install" I believe and I think is the most practiced.
One bionic brother here had infra-pubic done because he had two hernias and the mesh in his abdomen would've been more difficult to get through had they done penoscrotal.

My surgery was penoscrotal. I haven't lost any sensitivity.

Any other questions just ask :D
33yrs old. Coloplast Titan TOUCH
PenoScrotal 20cm + 1.5RTE
Dr. Bodie U of MN
ED Symptoms for 15 year. Physically fit.
During surgery, found narrowed blood vessels and scarring in penis.
Peyronies was not shape affecting but contributed to ED.

backup2014
Posts: 70
Joined: Mon Dec 01, 2014 1:54 pm

Re: Infra pubic or infra scrotal?

Postby backup2014 » Tue Feb 13, 2018 9:58 am

I would highly advise you to stay away from infra pubic. I think recovery is much longer, you will have a horrible scar and most likely nerve damage. I had infra pubic implant Dec 2014, revision Oct 2017. Now the tubing has loosened up and is causing a huge bump inside my pubic pad. I have to get this repaired in April. My surgeon has done over five thousand of these. Don't go infra pubic!!!
67, Married to my childhood sweetheart, semi retired. Implant Dec 2014 Dr. Dean Knoll Nashville TN, RPS March 2014. Implant failure July 2017 Revision Oct 2017, First Implant AMS 700 LGX 19CM, Revision AMS 700 MS 21CM.

TANGERINE
Posts: 401
Joined: Wed Feb 15, 2017 11:10 pm

Re: Infra pubic or infra scrotal?

Postby TANGERINE » Tue Feb 13, 2018 11:44 am

my surgeon told me that peno scrotal is far superior . With the scrotal approach, some advantages are:
nerve problems (numbness) are much less
pump placement can be more optimal
better hiding of the tubes (sometimes tubes along the top can be felt during sex if infra-pubic)
scar is hidden (cannot see it)--with infrapubic, your scar is just below the pubic bone, right where the women is looking while performing oral sex
"Strive hard to find the best implant surgeon -- surgical experience really matters"
(Titan 22cm implant Feb 2017 by Dr Eid) Great experience -- I'm super pleased with my length and girth and implant performance.

David_R
Posts: 1127
Joined: Mon Nov 02, 2015 1:03 pm
Location: Northeast Maryland

Re: Infra pubic or infra scrotal?

Postby David_R » Tue Feb 13, 2018 1:14 pm

backup2014 wrote:you will have a horrible scar

I don't care about a scar because it is not visible since it's covered by pubic hair. Wouldn't that me the case with most/all men?
Baltimore area. Age 68. Prostatectomy in 2000, CX inserted in 2002. Wore out after 12 yrs., got LGX in 2014. I am glad I had them both. My great urologist is Dr. Marc Siegelbaum. (After regular inflating I regained my original length and girth.)

TANGERINE
Posts: 401
Joined: Wed Feb 15, 2017 11:10 pm

Re: Infra pubic or infra scrotal?

Postby TANGERINE » Tue Feb 13, 2018 2:08 pm

here is a discussion on inra-pubic versus peno-scrotal that I found on the web (this is written by an experienced implant surgeon):
Question: Do you use the infra-pubic penile implant procedure, incision above the penis or the scrotal incision below the shaft of the penis? What are the advantages and disadvantages of these two methods?


Answer: I prefer the peno-scrotal (midline on the scrotum) incision because I believe that it offers several advantages for the patient and provides a much better cosmetic outcome. It is easier to accurately size the penis and therefore to give the patient the longest possible implant. It also facilitates a more accurate and better placement of the penile implant pump in the scrotum, which will make it easier for the patient to inflate and deflate the penile device after it heals. It enables the surgeon to place the penile implant with smaller incisions and enables the use of the "no-touch " technique thus reducing the risk of infection.

The incisions in the shaft of the penis are closed completely to prevent bleeding and no drains sticking out through the skin are needed after the surgery. These penis drains would have to be removed the next day requiring patients to stay in the hospital. Much better concealment of tubing connecting the penile implant pump to the cylinders is also obtained with the peno-scrotal incision, the input tubing exits from below the penile shaft instead of above, and therefore penile implant tubing is not wrapped around the base of the penis and is not palpable by the patient and sexual partner. No one needs to know! Input tubing from the cylinders in the shaft of the penis exists further back into the scrotum. Less cutting is needed to get to the penis especially in an overweight patient, which means less swelling, less bleeding, no need for drains and less risk of penile implant infection. The only advantage of the above the penis incision approach is that it is easier for the surgeon to place the reservoir. This last step is not a problem for an experienced surgeon, however.


There is also an interesting video discussing the infrapubic versus peno-scrotal techniques along with many other concepts. The moderator is Irwin Goldstein MD from san diego and the experts are Dr Eid from New York and Dr Perrito from Coral Gables. This is an hour long, but there is a lot said in the video.

https://www.youtube.com/watch?v=2Y8-cuQK5V4
"Strive hard to find the best implant surgeon -- surgical experience really matters"
(Titan 22cm implant Feb 2017 by Dr Eid) Great experience -- I'm super pleased with my length and girth and implant performance.

Greg1956
Posts: 963
Joined: Sun Aug 06, 2017 8:35 am
Location: Atlanta, GA USA

Re: Infra pubic or infra scrotal?

Postby Greg1956 » Tue Feb 13, 2018 2:46 pm

David_R wrote:
backup2014 wrote:you will have a horrible scar

I don't care about a scar because it is not visible since it's covered by pubic hair. Wouldn't that me the case with most/all men?


Manscaping has been very prevalent for several years, at least in large metro areas, with many guys going smooth or just leaving stubble. I was a nude model for artists and college art classes for many years and it is very common in that world to remove or minimize body hair. Since my surgery I have not started up again following implant surgery except for posing for a few close friends so for the first time in years I have let mine grow out.

Greg
I am 62 and had 30 years of ED. Implanted by Dr. Ronald Anglade in Atlanta on 9/18/17. I have an AMS LGX 18cm w/3cm RTE via a Penoscrotal incision. Currently 5” deflated and 6” inflated, 5.5” girth. Willing to Show & Tell.

LMCatman
Posts: 601
Joined: Wed May 08, 2013 11:11 am
Location: South Florida, USA

Re: Infra pubic or infra scrotal?

Postby LMCatman » Tue Feb 13, 2018 5:57 pm

I've had both....I think the skill of the surgeon is more important......
On my third Titan. 67 Years old. Radical Prostatectomy Oct 2010, No erections after, Botched Titan implant April, 2013, Successful Titan revision, April , 2014 by Dr. Paul Perito, Miami...Titan failure Feb 2017...revision by Dr Perito March 1st, 2017

Anonymous3
Posts: 1319
Joined: Thu Aug 03, 2017 9:43 pm

Re: Infra pubic or infra scrotal?

Postby Anonymous3 » Tue Feb 13, 2018 7:28 pm

I had the natural scar(deglove) the scar is right there withbthe circumcision scar

JTVallee
Posts: 36
Joined: Fri Mar 20, 2015 10:02 am
Location: Minnesota

Re: Infra pubic or infra scrotal?

Postby JTVallee » Wed Feb 14, 2018 4:51 pm

I had the infra pubic due to the double hernia being fixed with mesh
I lost no length and have no issues with pump or tubing, done 3 years ago
No lose of sensation
Can't say if healing was shorter or longer since everyone is different
No pain from the resivoir at all after surgery due to the ease of placement
I think a lot of it comes down to the skill and patience of the Dr because it takes a little more time and accuracy to get it all placed correctly
Titan OTR March 9th 2015 at age 48
ED all my life started with shots until oral meds became available the quit working went back to shots u til they quit then got my implant from Dr. Jodie U of Minnesota
Couldn't be happier


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