By using the minimally invasive technique, we are able to implant all the components of the hydraulic three-component prosthesis through a 2-cm incision at the base of the penis. The procedure can be safely performed under general, spinal, or local anesthesia in less than 25 minutes. Usually patients can resume sexual activity after 4 weeks. Description of the Technique: once the trichotomy is performed in the operating room, the skin is cleansed and disinfected for 10 minutes with an iodopovidone solution and injected cefazolin intravenously. The first step is the induction of a hydraulic artificial erection by injecting cavernosa with 0.9% salinity inside the corpora cavernosa. This maneuver makes it possible to identify any conditions to be corrected (e.g. “Hourglass” deformities or penis curvatures). Furthermore, it promotes the expansion of the corpora cavernosa and facilitates the identification of the dorsal nerve, positioning it sideways toward the suture points.
Clinical Background
The patient is a 62-year-old male
No Smoker
No Arterial Hypertension
No Smoker
2008 IVC filter placement
2012 Left hemicolectomy
2014 Diagnosis of Prostate Cancer Gleason 6 (3+3) bilateral
2014 Robotic Assisted Laparoscopic Prostatectomy (pT2c)
Undetectable PSA after surgery <0.01 ng/ml
Penile rehabilitation with Tadalafil 5 mg daily and Sildenafil 100 mg on demand for 8 months
After 8 months the patient reports chronic erectile dysfunction not responding to PDE5 inhibitors or intracavernous prostaglandin injection
3-piece hydraulic penile prosthesis was decided on: AMS LGX 700
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