"MINT" Infrapubic Penile Implant Technique

Love, C.

Minimally Invasive, No Touch, Infrapubic, Penile Implant

This video demonstrates a Minimally Invasive No Touch (MINT) technique in infrapubic penile implant placement. The approach is detailed in a step-by-step fashion focusing on minimizing the risk of infection in implant placement. A chlorhexidine preparation is used on the skin prior to shaving to reduce hair contamination and for ease of removal. A 4% alcohol based chlorhexidine scrub is used on the skin. A clear plastic drape is used to cover the gential area, all but 1cm of the proximal penis. The lower abdominal and infrapubic area is covered with Ioban drape. Glove changes are performed during the procedure every time the skin is touched or potentially touched. The skin incision is made through the Ioban and an Alexis retractor is used to expose the incision and cover the skin incision edges. Standard techniques for infrapubic placement of the cylinder and reservoir are performed. Copious amounts of a 1gram vancomycin in 1000mL normal saline solution are used in the incision and inside the corpora. The cylinders are presoaked in a solution of rifampin and gentamicin prior to implantation. The pump is soaked in antibiotic solution on the prep table and again just prior to implantation. Once the pump is placed, the remainder of the antibiotic solution is used in the Alexis retractor space. A JP drain is placed down in the scrotum and a trocar is used to pass it through the skin, lateral to the incision. A 3 layer closure is performed including subcuticular vicryl skin staples. Dermabond and a waterproof dressing are applied. The cylinders are left deflated for ease of patient voiding postoperatively. The penis is gently wrapped with Coban. A sandbag is placed over the incision for 1-2 hours