Shah s Penile Prosthesis Case 1
Conference Name: Live Operative Workshop on Andrology
Surgeon(s)/Speaker(s): Dr. Sanjay Pandey
Surgical Procedure: Urology-Penile Prosthesis
Location: Kokilaben Dhirubhai Ambani Hospital and research Institute Mumbai
Indexsteps
1. 1. Draping : Disposable draping of the sterile area
2. 2. Ioban exclusion of the sterile area : Ioban exclusion of the sterile area, catheterization with 16 Fr catheter with emptying of the bladder, block catheter
3. 3. Penile shaft : Penile shaft gentle stretch over the retractor
4. 4. Gloves changing : Change of gloves of the team
5. 5. Transverse penoscrotal incision : Transverse penoscrotal incision, deepened to the level of corporal bodies and urethra identified
6. 6. Stay sutures : Vicryl 2-0 stay sutures to delineate the site of corporal incision
7. 7. Incision : 1-2 cm longitidunal corporal incision
8. 8. Dilatation of the individual corpora : Dilatation of the individual corpora with Metzenbaum scissors and Hegar’s dilators proximally and distally
9. 9. Confirmation of the Goal post sign : Confirmation of the Goal post sign and Pinch test towards ideal satisfactory dilatation
10. 10. Antibiotic-laden irrigation of the bilateral corporotomy : Antibiotic-laden irrigation of the bilateral corporotomy and antibiotic irrigation of the field continuously
11. 11. Measurement of the length : Measurement of the length needed towards implantation
12. 12. Opening of the right measured Penile Prosthesis : Opening of the right measured Penile Prosthesis and antibiotic solution
13. 13. Sizing of the Prosthesis : Sizing of the Prosthesis
14. 14. Placement : Placement of the prosthesis bilaterally
15. 15. Antibiotic irrigations : Antibiotic irrigations
16. 16. Closure : Closure of the corporotomy
17. 17. Transverse skin closure : Transverse skin closure at the penoscrotal junction in layers and absorbable sutures
18. 18. Urobag placement : Sterile dressing, Urobag placement and fixation
19. 19. Mummy wrap dressing : Mummy wrap dressing of the Penoscrotal region
20. 20. Penile dressing : Penile dressing as needed
21. Case details : Case details
22. Pre Opt : Pre Opt
23. Catheterization : Catheterization
24. Case - 1 details : Case - 1 details
25. Incisions : Incisions
26. Dilation : Dilation
27. Dilation : Dilation
28. Penile Implant : penile implant
29. Incisions closer : Incisions closer
30. Case - 2 details : Case details
31. Silicone Catheterization : silicone catheterization
pre_post_measures
1. Preoperative measures : Counselling, realistic needs and assessment of failed medical therapy to be labelled as refractory ED :new:If diabetic, near euglycaemic controls :new:NO UTI, No bleeding disorders,No local skin lesions :new:Preoperative workup for anaesthesia fitness :new:Admit a day before, Preoperative antibiotics,Perineal betadine scrub and hygiene :new:ALWAYS THE FIRST CASE OF THE STERILE OPERATING THEATRE *Proper positioning :new:Shaving of lower abdomen, perineum, medial thighs after induction :new:Scrubbing of lower abdomen, perineum. Medial thighs with sterile solutions twice :new:Preoperative antibiotics, readiness of the operative trolley, set of prosthesis as required :new:Minimal traffic in the operating room
Surgical Instruments
1. Malleable Penile Prosthesis
2. 16 Fr Catheter
3. Penile Retractor
4. Vicryl 2-0 stay sutures
5. Metzenbaum scissors
6. Hegar’s dilators
7. Urobag