Society of Urologic Prosthetic Surgeons' Coding and Billing Position Statement on Ancillary/Adjunct Penile Prosthesis Surgical Procedures: Part I.

Objective: To create a society position statement on common adjunct penile prosthesis (PP) procedures. While the Medicare Current Procedural Terminology code book lists descriptions of procedures, it is very brief and lacks detail in the small subspecialty of prosthetic urology. At educational/research meetings, wide variation was found in how experts in prosthetic urology code the same procedures, and need for a standardized format in billing common ancillary surgery was voiced.

Penile fibrosis-still scarring urologists today: a narrative review.

Background And Objective: Implantation of penile prosthesis (PP) into scarred and fibrotic corpora can be a difficult challenge. In this review article, we provide a review of penile fibrosis, discuss current medical and surgical management and summarize preventative strategies.

Methods: In this study, we searched PubMed between the years 2000-2023 for publications with search strategy: "penile fibrosis" OR "scarred corpora" OR "fibrosed corpora".

Safety outcomes of the first Rigi10™ malleable penile prostheses implanted worldwide.

Implantation of penile prosthesis is considered when conservative measures fail or are unacceptable to patients' wishing treatment for erectile dysfunction. In the United States (US), inflatable penile prostheses are more often used than malleable penile prostheses (MPP). Outside the US, the reverse is true because third-party reimbursement is not available, and MPP is considerably cheaper.

Patient selection, counseling and preparation for penile prosthesis.

The penile prosthesis has revolutionized the management of erectile dysfunction and is a mainstay in the treatment of this clinical entity. The goal of proper patient selection and counseling is to achieve a satisfactory outcome for the patient. Most patients receiving a penile prosthesis are satisfied with their outcome, and while the penile prosthesis generally allows for high satisfaction rates, avenues for dissatisfaction can arise.

Three piece penile prosthesis salvage with chlorhexidine gluconate and length preservation: our technique and outcomes.

Objective: Since the advent of the Mulcahy technique of three-piece inflatable penile prosthesis (IPP) salvage, there have been multiple iterations of salvage prosthesis procedures reported in the literature. All of these techniques employ traditional antibiotic irrigation with or without rechanneling. We present our technique of salvage IPP using 0.

Circumcision and Sexual Medicine.

Introduction: Male circumcision is one of the most frequently performed and debated urological procedures due to its possible implications for sexual health.

Objectives: The objective of this article is to review the literature on male circumcision and reconcile the scientific evidence to improve the quality of care, patient education, and clinician decision-making regarding the effects on sexual function of this procedure.

Methods: A review of the published literature regarding male circumcision was performed on PubMed.

Penile Implant Instrument Innovations.

Purpose Of Review: Numerous innovations have been made since the first inflatable penile prosthesis was introduced in 1973-not just of the implant apparatus itself, but crucially also in the surgical instruments used for prosthetic surgery. Starting with Dr. Furlow's revolutionary inserter tool, advancements were quickly made in dilators, retractors, and cavernotomes.

Extended Reality-Assisted Surgery as a Surgical Training Tool: Pilot Study Presenting First HoloLens-Assisted Complex Penile Revision Surgery.

Background: Extended reality-assisted urologic surgery (XRAS) is a novel technology that superimposes a computer-generated image on the physician's field to integrate common elements of the surgical process in more advanced detail. An extended reality (XR) interface is generated using optical head-mounted display (OHMD) devices.

Aim: To present the first case of HoloLens-assisted complex penile revision surgery.

"Pumpology": the Realistic Issues Associated with Pump Placement in Prosthetic Surgery.

Purpose Of Review: The goal of this paper was to discuss the issues and/or overt complications associated with the 3-piece inflatable penile prosthesis (3-IPP) pump. We also addressed how to resolve such issues with or without surgical intervention.

Recent Findings: Numerous modifications of the 3-IPP pump have been introduced with multiple techniques to place the pump.

Current Status for Semirigid Penile Prosthetic Devices.

Purpose Of Review: The goal of this paper was to evaluate the current use of semirigid penile prosthesis (SRPP), surgical techniques for insertion of SRPP, and how to prevent and approach surgical complications.

Recent Findings: SRPP is a valid option for those who are refractory to medical therapy for erectile dysfunction (ED) and even more appropriate for specific subsets of patient populations. It is important for urologists to know which patient population SRPP is preferred for.

Inflatable penile prosthesis cylinders out of place during implantation.

It is safe to say that the overwhelming majority of cylinders out of place result from surgeon error at the time of implantation. There are some instances where patient comorbidities could increase the difficulty of accurate development of cylinder insertion or space. Most of the time the operator recognizes his instrument out of place and corrects it intraoperatively.

Distal Biologic Cap for Impending Distal Erosion.

Introduction: Management for distal impending erosion can be difficult and has been previously managed with counter incisions which can lead to unsightly scars and increased infection risk.

Aim: To demonstrate a novel technique in management of impending erosion.

Methods: We retrospectively reviewed patients who underwent placement of a distal biologic cap for impending erosion.

Multicenter Investigation of Fungal Infections of Inflatable Penile Prostheses.

Background: Fungal infections of inflatable penile prostheses (IPPs) are inadequately understood in the literature.

Aim: To review a multi-institution database of IPP infections to examine for common patient and surgical factors related to IPP fungal infections.

Methods: This is a retrospective Institutional Review Board-approved analysis of 217 patients at 26 institutions who underwent salvage or device explant between 2001 and 2018.

Multicenter investigation on the influence of climate in penile prosthesis infection.

The purpose of this study is to investigate the relationship between inflatable penile prosthesis (IPP) infection, time of year, climate, temperature and humidity. This is a retrospective IRB-approved analysis of 211 patients at 25 institutions who underwent salvage procedure or device explant between 2001 and 2016. Patient data were compiled after an extensive review of all aspects of their electronic medical records.

Management of Priapism: A Contemporary Review.

Introduction: Current management of ischemic priapism revolves around 3 principles: resolving the acute event, preserving erectile function, and reducing the risk of future recurrences. Although more conservative management options, such as aspiration, irrigation, and surgical shunts, are effective in many patients, those who are refractory to these interventions or have prolonged priapism may benefit from placement of a penile prosthesis (PP).

Aim: To provide a comprehensive overview of priapism management, highlight the current literature on the utility of penile implants for refractory priapism, and provide insight from a high-volume center on surgical decision making and technique.

Suprapubic Fat Pad Excision with Simultaneous Placement of Inflatable Penile Prosthesis.

Introduction: Many men suffering from erectile dysfunction are overweight with generous suprapubic fat pads, which often contribute to a decrease in visible exophytic phallic length.

Aim: To present a novel surgical concept of suprapubic fat pad excision with a concomitant placement of inflatable penile prosthesis.

Methods: A transverse incision begins slightly medial to the anterior superior iliac spine, with the superior edge crossing transversely to the contralateral anterior superior iliac spine.