Incision placement- disgusting

The final frontier. Deciding when, if and how.



Crtrader
Posts: 138
Joined: Tue Dec 10, 2019 2:32 pm

Incision placement- disgusting

Postby Crtrader » Wed Jan 29, 2020 7:00 am

My Doc says the incision under the penis( penoscrotal), is the Worst place - says it’s disgusting under there. I think he means more bacteria and chance of infection. He only does infrapubic or coronal. I’m getting a semi rigid so he’s going coronal. He says it’s the best, easiest way to place it. Even Boston Scientific has a video showing the coronal approach.

Waynetho
Posts: 1768
Joined: Wed Nov 27, 2019 11:22 pm
Location: Dallas, TX

Re: Incision placement- disgusting

Postby Waynetho » Wed Jan 29, 2020 9:57 am

Before going with subcoronal, be sure you ask him about loss of sensation in the skin surrounding the circumcision scar. Even though they do a similar circumcision cut, the penis is degloved to a degree and there may be some nerve compression and possibly damage which could affect peripheral sensations to the penis. As long as the NV bundle (neurovascular) running down the middle of the dorsal side of the penis, that feeds sensations and blood to the glans is undamaged you will still retain the majority of sensations but I would be concerned with a degloving, that I would lose too much sensation AROUND the penis in that area. I'm still numb to a degree in the skin of my penoscrotal incision some 93 days later.
64yo, married 43 yrs. Urolift (x4) 8/12/19. AMS 700CX 15cm (no RTE) penoscrotal 10/28/19, Frisco, TX. PD 1995/ED 2011. Cialis helped but hinged. (1995)L:6/G:5.5+, (2019)Pre-op L:5/G:4.5, (2/2020)L:6.0/G:5.0

Crtrader
Posts: 138
Joined: Tue Dec 10, 2019 2:32 pm

Re: Incision placement- disgusting

Postby Crtrader » Wed Jan 29, 2020 1:06 pm

Thanks for your reply . I will ask about the nerves and sensation. He did mention same as circumcision. What does the term degloved mean? Thanks

Lost Sheep
Posts: 6174
Joined: Mon Jul 04, 2016 11:16 pm

Re: Incision placement- disgusting

Postby Lost Sheep » Wed Jan 29, 2020 1:40 pm

Crtrader wrote:Thanks for your reply . I will ask about the nerves and sensation. He did mention same as circumcision. What does the term degloved mean? Thanks

Essentially, a circumcision of the entire penis shaft from the corona at the glans to the scrotum. Then, after the operation is finished the skin is pulled back up in place.

Think of a long-sleeved shirt. Unbutton the cuff and pull the sleeve back, baring the arm. You do the operation on the exposed flesh and then pull the sleeve back down.

The only scar is right behind the coronal ridge where it is virtually hidden.

It is an alarming-LOOKING operation, but really quite simple and safe.
Lost Sheep
AMS LGX 18+3 Nov 6, 2017
Prostate Cancer 2023
READ OLD THREADS-ask better questions -better understand answers
Be part of your medical team
Document pre-op size-photos and written records
Pre-op VED therapy helps. Post-op is another matter

Waynetho
Posts: 1768
Joined: Wed Nov 27, 2019 11:22 pm
Location: Dallas, TX

Re: Incision placement- disgusting

Postby Waynetho » Wed Jan 29, 2020 1:42 pm

Crtrader wrote:Thanks for your reply . I will ask about the nerves and sensation. He did mention same as circumcision. What does the term degloved mean? Thanks


Deglove means as it sounds, just like talking a glove off you're hand, the skin is pushed down toward the tip or base, degloving a penis means to pull the skin down in some way to expose the tissues below. Many tunica albuginea repairs involve degloving or performing a circumcision cut and then pulling the skin down the penis toward the base of the shaft.
64yo, married 43 yrs. Urolift (x4) 8/12/19. AMS 700CX 15cm (no RTE) penoscrotal 10/28/19, Frisco, TX. PD 1995/ED 2011. Cialis helped but hinged. (1995)L:6/G:5.5+, (2019)Pre-op L:5/G:4.5, (2/2020)L:6.0/G:5.0

WhiteCane
Posts: 350
Joined: Wed Sep 11, 2019 8:10 pm

Re: Incision placement- disgusting

Postby WhiteCane » Wed Jan 29, 2020 2:33 pm

Infection is a weird defense for this one… Sorry… by degloving, he’s going to be exposing you to a lot more germs… This is a little bit riskier considering both the exposure to the air and how distal the organ being cut into is… just some stuff to bring up… Best of luck, my friend…
Implanted October 2019 Dr. Kramer lgx 18 cm +2 rear tips. Preop at 6.75 post op 5.25... awaiting revision… Implanted for possibility of having our first child.

Gt1956
Posts: 3180
Joined: Fri Apr 05, 2019 2:47 pm

Re: Incision placement- disgusting

Postby Gt1956 » Wed Jan 29, 2020 3:04 pm

Layman's opinion. As surgical technic's have advanced. There is definate trend towards minimizing the surgical opening & the amount of tissue that is disturbed. This has really reduced recovery time, infection risk & other things. I can't picture in my mind that this is a step forward for penile implants. Ya, I get that it is done in a controled manner. But it is similar to rolling your socks down. Basically your entire penis will be scalped thus exposed to the air.
The term degloved comes from the results of industrial accidents. The flesh of a hand or finger is ripped off like it is a glove. Not on my penis they won't. That would be a huge wound to recover from in my opinion.
69yo, HBP @ 40, high triglycerides @ 45. Phimosis @ 57. Type 2 @ 60. Dr. William Brant May 1, 2023 CX 21cm w/no rte's penoscrotal 6" girth @ 6 months.

Lost Sheep
Posts: 6174
Joined: Mon Jul 04, 2016 11:16 pm

Re: Incision placement- disgusting

Postby Lost Sheep » Wed Jan 29, 2020 3:30 pm

Gt1956 wrote:Layman's opinion. As surgical technic's have advanced. There is definate trend towards minimizing the surgical opening & the amount of tissue that is disturbed. This has really reduced recovery time, infection risk & other things. I can't picture in my mind that this is a step forward for penile implants. Ya, I get that it is done in a controled manner. But it is similar to rolling your socks down. Basically your entire penis will be scalped thus exposed to the air.
The term degloved comes from the results of industrial accidents. The flesh of a hand or finger is ripped off like it is a glove. Not on my penis they won't. That would be a huge wound to recover from in my opinion.

I am also a layman.

Yes, it is clear that degloving the penis exposes a LOT more surface area of one's insides to air (and the attendant potential for infection).

It also puts the incision into the tunica a bit more distal than a pubic incision and even more so than a peno-scrotal incision. A position that puts the tubing further up the penis seems to me to be less desirable.

So, why do it that way?

The actual incision in the skin is in a location where it is easier to keep clean and is less visible.

The skin of the penis (seems to me) to be less "attached" to the underlying tissue than typical skin, so is easily pulled back.

So, it is a viable option.

Still, the concept gives me the "willies". And, since I asked for a vasectomy at the same time as the implant (contemplating the unlikely potential for sex with a woman young enough to be in child-bearing years), the scrotal approach was the obvious choice.

If you want to see a truly alarming scrotal approach disaster, see the thread from Random255 (with pictures). It makes the de-gloving approach a LOT more attractive. But, then, the consensus of opinion on that case was that the surgeon was a hack.
Lost Sheep
AMS LGX 18+3 Nov 6, 2017
Prostate Cancer 2023
READ OLD THREADS-ask better questions -better understand answers
Be part of your medical team
Document pre-op size-photos and written records
Pre-op VED therapy helps. Post-op is another matter

Crtrader
Posts: 138
Joined: Tue Dec 10, 2019 2:32 pm

Re: Incision placement- disgusting

Postby Crtrader » Wed Jan 29, 2020 5:03 pm

I read the Boston Scientific article on how to implant a Tactra coronal. There is NO “degloving”. They go in under the glans and insert the end straight down, then cover with the tip and sew you up. BTW : Boston scientific does not even publish a video on doing it penoscrotal They recommend coronal or infrapubic. Again- talking about a semi rigid.

Crtrader
Posts: 138
Joined: Tue Dec 10, 2019 2:32 pm

Re: Incision placement- disgusting

Postby Crtrader » Thu Jan 30, 2020 9:19 am

No “degloving”.


Return to “Implants”

Who is online

Users browsing this forum: dj_soros, rob8278 and 22 guests