Assistant Training in Infrapubic Inflatable Penile Prosthesis Surgery

N. Pumfrey, S. Middela, I. Pearce, V. Modgil, T. Stasinou

Inflatable penile prosthesis; Prosthetic urology; Surgical education; Assistant training; Infrapubic approach; Operative efficiency

Inflatable penile prosthesis surgery is a complex prosthetic urology procedure in which operative flow, anticipation of surgical steps, and efficient assistance are important to minimize delay, reduce infection risk and maintain a controlled operative field1. Existing educational material predominantly focuses on the primary surgeon, with limited attention given to the role of the assistant, despite the assistant being central to exposure, suction, instrument readiness, implant preparation, corporotomy support, tubing management, closure, and overall theatre efficiency. This video was developed as a structured educational resource for trainees assisting in infrapubic inflatable penile prosthesis insertion. It guides the assistant through the full operative pathway, including preoperative preparation, draping, stretched penile length measurement, artificial erection testing, infrapubic exposure, corporotomy assistance, corporal dilation, cylinder preparation and placement, pump and reservoir insertion, tubing connection, closure, drain placement, dressing, and postoperative transfer. The video is designed to improve role clarity, procedural familiarity, confidence, and anticipation of key operative steps, thereby reducing the need for intraoperative teaching during the case. A preliminary pilot evaluation using a validated six-domain surgical confidence questionnaire2 demonstrated higher total confidence scores in trainees who viewed the video before assisting compared with controls who had not viewed the video. This video is of interest to sexual medicine surgeons and trainees because it addresses an overlooked aspect of prosthetic urology training: improving the performance and confidence of the assistant rather than solely teaching the primary surgeon.

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1. Jarow JP. Risk factors for penile prosthetic infection. J Urol. 1996;156(2 Pt 1):402-404.

2. Geoffrion R, L T, S J. Validating a self-confidence scale for surgical trainees. J Obstet Gynaecol Can. 2013;35(4):355-361.