ORIGINAL RESEARCH—SURGERY: Surgical Technique to Maintain Penile Length After Insertion of an Inflatable Penile Prosthesis via Infrapubic Approach


Fernando Borges, MD, Pinellas Urology, 5747 38th Avenue N, St. Petersburg, FL 33710, USA. Tel: (727) 381-8667; Fax: (727) 384-3905; E-mail: fborgess@tampabay.rr.com


Introduction.  The aim of this study was to provide an overview of the principal author's experience in maintaining penile length after implantation of a three-piece inflatable penile prosthesis (IPP). For many patients with erectile dysfunction, who choose surgical treatment, loss of penile length after implantation of an IPP is a common concern. In the principal author's experience, release of the suspensory ligament during IPP implant surgery can maintain penile length, alleviating this concern.

Methods.  After implantation with an IPP, the principal author released the patient's suspensory ligament.

Main Outcome Measures.  The main outcome measure was patient satisfaction with penile length after IPP surgery. A second outcome measure was a substudy measuring the patient's penile length after IPP implantation both before and after suspensory ligament release.

Results.  From August 1997 through September 2002, the principal author implanted a total of 303 Alpha 1 IPPs into men who suffered from erectile dysfunction (ED). All had their suspensory ligament released. Postoperative complications were minimal and for the most part transitory. Ninety-three percent reported satisfaction with IPP performance, penile length, and willingness to undergo the IPP surgery again. None of the patients reported penile shortening, with some of them reporting an increase in penile length, as compared with preoperative measurements.

Conclusion.  Release of the suspensory ligament appears to maintain or even increase penile length, with a minimum of complications, and a high degree of patient satisfaction. Borges F, Hakim L, and Kline C. Surgical technique to maintain penile length after insertion of an inflatable penile prosthesis via infrapubic approach. J Sex Med 2006;3:550–553.