Tips and Tricks of Subcoronal Exposure

P. H. Egydio

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

Abstract

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.

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