Urology Clinical Abstracts

Dr. Paul Perito has published and presented a number of important penile implant articles and papers regarding men’s sexual health.

Foley Catheterization Is Not Routinely Necessary During 3-Piece Inflatable Penile Prosthesis placement

Edward L. Gheiler, MD, Paul Perito, MD, Isabel H. Lopez, MD, Maximiliano Sorbellini, MD, Fernando J. Bianco, MD, Miami, FL
Presented at the 2011 Sexual Medicine Society of North America Conference, Las Vegas, NV

Many urologists believe that an indwelling Foley catheter is required during inflatable penile prosthesis (IPP) placement in order to avoid both urethral and bladder injuries. We aim to demonstrate that experienced prosthetic surgeons can perform IPP with a low incidence of injury and/or infection.

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Option to Under-fill Titan® CL Reservoir for Alternative/Ectopic Placement

Paul Perito, MD FACS (Miami, FL), Edward Gheiler, MD FACS, Fernando J. Bianco, MD, Steven K Wilson, MD FACS FRCS
Presented at the 2011 Sexual Medicine Society of North America Conference, Las Vegas, NV

Increasing data suggests desire for reservoir placement outside of (traditional) space of retzius. New technology allows this concept and physician’s intra-op ability to further customize each implant. New Titan® Cloverleaf reservoir (Coloplast Corp, Minneapolis) allows ease of alternative placement with ability to underfill to maintain aesthetic patient satisfaction, in non-traditional reservoir space.

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Early Experience with the Coloplast Titan® CL Reservoir 

Arnold Bullock, MD, J. Antonio Alarcon, MD, William Brant, MD, Edward Gheiler, MD, Tobias Kohler, MD, Andrew Kramer, MD, John Ludlow, MD, Paul Perito, MD, Gary Price, MD, Hossein Sadeghi-Nejad, MD, Christopher Steidle, MD, Robert Valenzuela, MD
Presented at the 2011 Sexual Medicine Society of North America Conference, Las Vegas, NV

Coloplast’s Titan CL reservoir was designed to improve ease of implant with a new four lobed design for easier surgical placement by folding the lobes to create a lower profile. The shortened length of the reservoir also allows for less distal dissection of the space of retzius prior to implant.

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Local vs General Anesthesia:  A Comparative Analysis for Multi-component Penile Prosthesis Implantation

Dominic Lee, MD (Houston, TX), Paul Perito, MD (Coral Gables, FL)
Presented at the 2011 Sexual Medicine Society of North America Conference, Las Vegas, NV

Despite good tolerability and outcome measures, local anesthesia (LA) for multi-component penile prosthesis (IPP) surgery has lost favour. We report our consecutive cohort of men undergoing penile prosthesis implantation with both local and general (GA)/spinal anesthesia looking at intra and post-operative outcomes.

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A Novel Technique for the Correction of Peyronie’s Plaque During Inflatable Penile Prosthesis Placement

Paul E. Perito, MD, FACS, Edward Gheiler, MD, FACS, Fernando J. Bianco, MD, Chase Vanerpol, RA, Alfredo Suarez-Sarmiento Jr., RA, Alfredo Suarez-Sarmiento, MD (Miami, FL)
Presented at the 2011 Sexual Medicine Society of North America Conference, Las Vegas, NV

Retrospective review of 38 patients (1/11-6/11) with simultaneous modification of Peyronie’s curvature during implantation of IPP. All IPP were Coloplast Titan (previously Mentor) implanted by one surgeon. All patients were first time (virgin) implants with intra corporal incision of plaque conducted before IPP cylinders placed.

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Hispanic Male Satisfaction with 3-piece Inflatable Penile Prosthesis Validated by Erectile Dysfunction Inventory of Treatment Satisfaction

Edward L Gheiler, MD, Paul Perito, MD, Juan Guerra, MD, Isabel H Lopez, MD, Gustaveo PenaLaGrave, MD, Maximilliano Sorbellini, MD, Fernando J Bianco, MD, Miami FL
Presented at the 2011 Sexual Medicine Society of North America Conference, Las Vegas, NV

Over the last decade, objective validated questionnaires measuring subjective perceptions have improved our understanding of erectile dysfunction treatment.  We employed the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) to assess fulfillment  among Hispanic men who received a 3-piece Inflatable penile prosthesis (IPP).

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Safety of Inflatable Penile Prosthesis Insertion in Patients on Anticoagulant Therapy: a Report of 20 cases.

Paul E Perito, John A Grimaldi, John J Mulcahy, Steven K Wilson
Presented at the 2011 Southeastern Section of the AUA Conference, New Orleans, LA

IPP commonly indicated for patients with ASCVD. Some cannot temporarily discontinue anticoagulants for surgery. We review our combined experience in placing prosthesis in this unique group of patients while on anticoagulants.

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Repair of Meatal Laceration during prosthesis implantation allows preservation of implant.

Perito P., Gheiler E.
Presented at 2010 Annual Meeting Sexual Medicine Society of North America, Miami, Florida.

Distal urethral laceration occurs infrequently during dilatation or Furlow passage in implantation of a penile prosthesis. The tunica albuginea is the thinnest at the meatus. Classical management has been absortion of the implantation requiring patient return at a later date for another surgical attempt. We report a novel and simple repair that preserves the implanted prosthesis and avoids patient disappointment and the need for a second surgery. 

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Abdominal Wall Reservoir Placement in Patients with Compromised Retroperitoneum via Penoscrotal or Infrapubic Incisions

Perito P., Wilson S.
Presented at 2010 Annual Meeting Sexual Medicine Society of North America, Miami, Florida.

Patients for inflatable penile prosthesis (IPP) may have anatomy making reservoir placement in the Space of Retzius problematic. Recent popularity of robotic prostatectomy has created a larger pool of these patients. These patients’ reservoirs can be implanted in the abdominal wall in an “ectopic” versus the traditional location to avoid the compromised retroperitoneum. The Coloplast reservoir lockout valve, meant to prohibit auto-inflation, may be invalidated in ectopic placement. We distinguish with medical illustration the difference between traditional and ectopic reservoir placement from both infrapubic and penoscrotal incisions and prevention of valve malfunction. 

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Safety and Efficacy of Inflatable Penile Prosthesis Insertion in Patients on Anticoagulant Therapies:  A report of 12 cases

Grimaldi J., Mulcahy J., Perito P., Wilson S.
Presented at 2010 Annual Meeting Sexual Medicine Society of North America, Miami, Florida.

Inflatable penile prosthesis (IPP) is commonly indicated in patients with cardiovascular disease. Some of these patients require long-term anticoagulant therapies and are unwilling or unable to wait until the anticoagulation therapy is discontinued before proceeding with IPP surgery. We review our combined experience in this group of unique patients. 

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Correlation of Pre-op Stretch-Test & Post-op Penile Measurement for Inflatable Penile Prosthesis (IPP)

Paul E. Perito, MD FACS, Jose Guerra, MD, Anna Moscowitz, (Miami, FL)
Presented at the 2009 Sexual Medicine Society of North America Conference

The goal of this study was to further describe and illustrate a simplified approach for the infra-pubic inflatable (three-piece) penile prosthesis and review its efficacy, post-operative morbidity, and resultant patient return to function.

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The Minimally Invasive Infrapubic Inflatable Penile Prosthesis: A 1000-Patient Review

Paul E. Perito, MD FACS, Jose Guerra, MD, Anna Moscowitz, (Miami, FL)
Presented at the 2009 Sexual Medicine Society of North America Conference

The goal of this study was to further describe and illustrate a simplified approach for the infra-pubic inflatable (three-piece) penile prosthesis and review its efficacy, post-operative morbidity, and resultant patient return to function.

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Intra-facial Placement of the Penile Prosthesis Reservoir: A Novel Technique for the High Risk Patient

Paul Perito, MD; Omar Pacha, BS; Mohit Khera, MD, MBA
Presented at the 2009 Sexual Medicine Society of North America Conference

Bowel or bladder injury during placement of a penile prosthesis reservoir can be a devastating complication. Certain patients, such as cystectomy patients or those with multiple abdominal surgeries, are known to be much more susceptible to this complication. In this study we examine a novel technique of an intra-facial placement of the penile prosthesis reservoir to mitigate the risk of bowel or bladder injury. 

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