Subcoronal Approach for penile deformities correction and lengthening - Tips and Tricks

Paulo Henrique Egydio

Subcoronal incision, penile prosthesis, inflatable implant, malleable prosthesis, no-touch technique, penile reconstruction

The subcoronal incision was first described by Smith in 1981 for the insertion of semirigid

penile prostheses, representing an important step in prosthetic urology. Building upon this

foundational technique, the author (Paulo H. Egydio) was the first to adapt and apply the

subcoronal incision to inflatable penile prosthesis (IPP) implantation in 2008. Over time, this

approach proved to offer complete access to the penile shaft, crura, scrotum (for pump

placement), and space for reservoir insertion—all through a single, circumferential incision.

This adaptation allowed for comprehensive penile reconstruction, correction of fibrosis and

curvature, glans fixation, and cylinder anchoring without the need for additional incisions. It

also enabled the application of a strict no-touch technique to minimize infection risk.

Following its introduction for inflatable prosthesis placement, this approach was later

disseminated and popularized internationally by other authors, notably Dr. Robert

Valenzuela and Dr. Sean Park, whose publications contributed to its wider recognition.

Current literature supports the safety, effectiveness, and versatility of the subcoronal incision

in both primary and complex prosthetic surgeries.

This video presents a detailed, step-by-step surgical guide to the subcoronal approach,

highlighting anatomical exposure, technique refinements, and decision-making strategies for

penile prosthesis surgeons seeking an efficient, minimally invasive solution for both

malleable and inflatable implants.

1. Smith AD. Circumcision incision for insertion of semirigid penile prosthesis. Urology

1981;18:609.

2. Egydio PH. Surgical treatment of Peyronie's disease: choosing the best approach to

improve patient satisfaction. Asian J Androl 2008;10:158–166.

3. Egydio PH, Sansalone S. Peyronie's reconstruction for maximum length and girth gain:

geometrical principles. Adv Urol 2008;2008:205739.

4. Weinberg AC, Pagano MJ, Deibert CM, Valenzuela RJ. Sub-coronal inflatable penile

prosthesis placement with modified no-touch technique: a step-by-step approach with

outcomes. J Sex Med 2016;13:270–276.

5. Park SH, Wilson SK, Wen L. Subcoronal incision for inflatable penile prosthesis does not

risk glans necrosis. J Urol 2023;210:678–687