The bottom line: No one needs to know that a penile implant is inside the penis except for the bearer himself! Please see pictures of implanted patients in the Photo Gallery section of the website.
Penile Implant Surgery: Objectives and Strategy
World-renowned urologist Dr. J. Francois Eid talks about his objectives and strategy when placing a penile implant (penis pump) for erectile dysfunction.
By abiding by a series of surgical principles, Dr. Eid has developed the Cosmetic Penile Implant.
These principles include:
1. Complete concealment of surgical scar
Unlike other surgical approaches that use an incision above the penis, or use a horizontal scrotal incision or the traditional longer midline scrotal incision, Dr. Eid uses a very small, one inch (the smallest ever), midline scrotal incision on the flat anterior surface of the scrotum, an inch away from the penile shaft. Although this type of incision requires more experience and surgical skill from the surgeon and causes a slight increase in surgical time, it offers the patient several significant advantages. Faster healing, with nearly invisible scar concealed by the midline scrotal raphe (darker line on the midline of the anterior surface of the scrotum), less bleeding, less post-operative swelling and quicker activation of the implant. As can be seen by the pictures of implanted patients the scar is not visible.
2. Concealment of input tubing connecting penile pump to cylinders
Dr. Eid developed a surgical technique of placing the tubing that exits the penile implant cylinders from the shaft of the penis to the scrotal pump deep and in the center of the scrotal sac. This buries the pump tubing that otherwise feels like a thick wire in the scrotal sac, away from the skin and the base of the penis. As a result, neither the patient nor one’s sexual partner will see or feel the tubing. This is not possible to do if the surgery is performed by making the “cut” above the penis, in this situation the tubing exits the penis from above and is wrapped around the base before it can be placed in the scrotum, or if the surgery is performed through the transverse or longer traditional scrotal incision.
3. Posterior placement of scrotal pump
Accurate, precise placement of the penile pump Dr. Eid believes is the most technically difficult part of the operation. Most surgeons pay very little attention to this part of the procedure. They merely push and shove the pump into the scrotal sac, using excessive force and dissection, resulting in post-operative swelling and requiring a post-operative pressure compression dressing. As a result, the position of the pump is often unpredictable. In addition, very little effort is made to conceal the penile pump and it is often visible to the naked eye. Finally, the patient’s partner will also see and feel the pump during intercourse and in the worst case scenario, the pump may even interfere with deep penetration. Dr. Eid’s technique places the penile pump behind the testicles, in the middle of the scrotal sac, optimizing cosmetic appearance while maintaining access and ease of use.
4. Deep positioning of reservoir
Less experienced surgeons are unfamiliar with techniques of placing the reservoir in the pelvic area. This results in a superficial location of the reservoir and creates a visible palpable bulge in the lower abdominal region near the groin. In addition, the reservoir wire-like tubing will also be seen and felt by the patient and partner at the base of the penis. It may even be uncomfortable during sexual activity. Dr. Eid uses a narrow space between the base of the shaft of the penis and the spermatic cord to access an area deep in the pelvis. Placed in this fashion, the reservoir is neither felt nor seen and the tubing is concealed by the spermatic cord of the testicle.
Meticulous attention to detail and precise minimal dissection are Dr. Eid’s main objectives in developing the cosmetic penile implant technique.