TY - JOUR T1 - Infrapubic surgical approach for penile prosthesis surgery: Indications and technique JO - Actas Urológicas Españolas (English Edition) T2 - AU - Picola Brau,N. AU - Torremadé,J. SN - 21735786 M3 - 10.1016/j.acuroe.2019.10.006 DO - 10.1016/j.acuroe.2019.10.006 UR - https://www.elsevier.es/en-revista-actas-urologicas-espanolas-english-392-articulo-infrapubic-surgical-approach-for-penile-S2173578620300615 AB - ContextPenile prosthesis surgery is currently the most effective treatment for erectile dysfunction when medical treatment is ineffective or contraindicated. Among the surgical approaches described in the literature, the scrotal, infrapubic and subcoronal are the most common in the daily clinical practice. ObjectivesThe main objectives were to describe the infrapubic surgical technique evaluating its indications and complications, as well as comparing its advantages and disadvantages with the penoscrotal approach. Acquisition and synthesis of the evidenceA literature review from 1983 until current date was carried out in Medline (PubMed and Cochrane Library databases) following PRISMA standards. Sixteen studies were included: 4 prospective, 4 retrospective, one systematic review, one randomized trial, one original article, 5 expert opinion/surgical technique descriptive paper. DiscussionAccording to the literature reviewed, although the penoscrotal approach is the most applied, the infrapubic approach showed a shorter operative time and a tendency for an earlier recovery of sexual activity after surgery. Complications are rare, having similar rates to the penoscrotal approach; no cases of glans hypoesthesia have been reported and peri-prosthetic infection rates were less than 3%. Satisfaction rates of infrapubic penile prosthesis were higher than 80%. ConclusionsPenile prosthesis implantation requires of a profound knowledge of the different surgical approaches in order to best adapt each technique based on each individualized case. The infrapubic approach, even if it is not the most used, is as feasible and reliable as the penoscrotal approach. The infrapubic approach is effective and safe, with high level of both, patients and partners’ satisfaction. ER -