Do IPP Implants Need to Be Accompanied by Extreme Adjunctive Procedures? Another Great Debate at the 27th Annual SMSNA Fall Scientific Meeting
On Friday, October 9, at the 27th Annual SMSNA Fall Scientific Meeting, Drs. Martin Gross and Laurence Levine engaged in a debate surrounding the management of erectile dysfunction (ED) with Peyronie's disease (PD) using inflatable penile prostheses (IPP). Is less truly more, or is maximal therapy the best option?
Dr. Gross argued that less is more, citing the recent PUMP study, which found that implantation alone was often sufficient. Specifically, the study reported that grafting was needed in only about 2% of cases. He stated that the preferred choice is often the simplest approach, with modeling and the scratch technique used as needed when curvature is under 45 degrees. Manual modeling can often reduce the curvature enough for the implant to provide further correction. The scratch technique is typically used as an adjunct procedure to disrupt plaque. When curvature exceeds 45 degrees, the implant can still provide much of the correction, with plaque incision using the Brock technique when necessary. This approach may mitigate some of the risks associated with multiple adjunctive procedures, such as hematoma, sensation loss, and glans necrosis.
Dr. Levine argued for a more extensive approach to achieve maximum correction. He emphasized that this approach may help address patients' concerns about lost penile length. The question is whether surgeons can safely and effectively restore length to its pre-PD state. If the goal of IPP surgery in patients with PD and ED is to recover lost length and girth, correct curvature or deformity, and make the penis functionally straight and rigid, the challenge may lie in the unpredictable anatomy of the neurovascular bundle within Buck's fascia. Unfortunately, the risks of IPP surgery may limit the ideal result. Dr. Levine highlighted the tunica expansion procedure (TEP), which uses small incisions in the tunica albuginea to allow the penis to expand during prosthesis implantation. Using TEP, patients experienced an average improvement of 1.7 cm in stretched penile length, with relatively few complications reported. Dr. Levine concluded that TEP is a reasonable option for patients who experience significant distress from penile length or girth loss.
When treating PD and ED with penile implants, is a simpler approach sufficient, or should surgeons aim to restore as much penile length and function as possible?
You may also be interested in...
Other Popular Articles
What Is the Average Penis Size?
If you have ever wondered how your penis compares to others in terms of size, you are not alone. Many men are curious to know how their penises stack up compared to the average. Unfortunately, general curiosity can sometimes give way to full-on obsession and anxiety about penis size. This can be an unhealthy and often unnecessary fixation, especially because most men who think their penises are too small have perfectly normal-sized penises.
Can Sex Reduce Menstrual Cramps?
The SMSNA periodically receives and publishes ‘guest editorials.’ The current article was submitted by Mia Barnes, a freelance writer and researcher who specializes in women's health, wellness, and healthy living. She is the Founder and Editor-in-Chief of Body+Mind Magazine.
Having sex while you experience menstrual cramps is healthy and can provide significant benefits. While it might not be the first activity that comes to mind when your PMS or period cramping begins, many people enjoy sex to reduce menstrual cramps, experience increased pleasure and benefit from other advantages. Learn more about having sex while menstrual cramps are happening and how it can help your body.
What Is Sensate Focus and How Does It Work?
Sensate focus is a technique used to improve intimacy and communication between partners around sex, reduce sexual performance anxiety, and shift away from ingrained, goal-oriented sexual patterns that may not be serving a couple.
What Is Jelqing, and Does It Actually Work?
The term “jelqing” refers to a set of penis stretching exercises that some believe can make the penis bigger. Although the practice has gained attention and popularity in blogs and internet forums in recent years, there is no scientific evidence that it is an effective way to permanently increase the size of one’s penis. In fact, in some cases, jelqing may actually cause damage to the penis, so it is a good idea to get all the facts before setting off to try it.
How Long Does It Take the Average Man to Ejaculate?
On average, it takes a man between 5 to 7 minutes to orgasm and ejaculate during sexual intercourse.
Can Sex Throw off Your Vaginal pH Balance?
The SMSNA periodically receives and publishes ‘guest editorials.’ The current article was submitted by Mia Barnes, a freelance writer and researcher who specializes in women's health, wellness, and healthy living. She is the Founder and Editor-in-Chief of Body+Mind Magazine.
Your vagina is a pretty powerful organ. It is a pathway for menstrual blood and babies. It also is a main player in sexual intercourse. You might hear about your vagina’s pH and worry that yours is at risk. Here’s what to know about vaginal pH, including the impacts sex could have.
Attention: Restrictions on use of SMSNA content in third party applications, including artificial intelligence technologies, such as large language models and generative AI.
You are prohibited from using or uploading content you accessed through this website into external applications, bots, software, or websites, including those using artificial intelligence technologies and infrastructure, including deep learning, machine learning and large language models and generative AI.
Subscribe for our Newsletter!
