ESSM – Texbook of Urogenital Prosthetic Surgery 1 Ed. 2021 (Incluye Ebook)

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SECTION I General Contents

CHAPTER 1 The History of the Penile Prostheses

First descriptions and management of erectile dysfunction

Initial attempts at penile prosthesis for the treatment of ED

1974 to Today

Current considerations and new directions

CHAPTER 2 Historical Aspects of the Artificial Urinary Sphincter

Early Devices

Evolution of the American Medical Systems (AMS) devices

AMS 800

CHAPTER 3 Functional and Surgical Anatomy in Erectile Dysfunction Restoration Surgery

Smooth Muscle Anatomy

Tunical anatomy


Vascular anatomy

Space of retzius anatomy

Extraperitoneal anatomy


Other anatomical considerations

CHAPTER 4 Functional and Surgical Anatomy in Male and Female Incontinence Surgery

General concepts of stress urinary incontinence

Female anatomy

Male anatomy

CHAPTER 5 General Aspects for a Correct Penile Prosthesis Implant Strategy


Patient selection

Surgical logistics

CHAPTER 6 How to Set Up a Prosthetic Urology Centre


The unconditional advantage of a dedicated team

Pre‑ and post‑operative involvement of dedicated nurses

The next step: growing and teaching


SECTION II Erectile Restoration (Inflatable Penil Prosthesis Placement-IPP Placement)

CHAPTER 7 Preoperative Assessment

Penile prostheses

Informed consent

Medical clearance

Patient personal preparation

Skin preparation


MRI, metal detectors

CHAPTER 8 Basic Scrotal and Infrapubic Techniques


Penoscrotal vs. infrapubic approach

The penoscrotal (PS) approach

The infrapubic (IP) approach

Salient features of each approach

CHAPTER 9 Intraoperative Management I

Antibiotic use

Foley catheter placement

Incisions and retractors

Corporal dilation and implant placement

Cylinder choice

Cylinder sizing

Ambicor‑rod width sizing

Cylinder placement

Corporotomy closure

PTFE sleeve

CHAPTER 10 Intraoperative Management II

Reservoir placement

Iliac Vessel injury

Bladder injury

Pump placement

Routing of tubing

Tubing length (inadequate or redundant)

Use of drains

Simultaneous surgery

Skin closure‑wound dressing

Semi‑inflation of an IPP

Special considerations

CHAPTER 11 Postoperative Considerations I


Penile Positioning

Postoperative visits and wound care

Cycling the device

Corporotomy disruption

Cylinder aneurysm

Impendingcylinder erosion (laterally or into the urethra)

Cylinder erosion (laterally or into the urethra)

Reservoir erosion into the bowel or bladder

Impending pump or tubing erosion

Disrupted outer silicone layer

Presence of calcified matrix (putty) or calcified biofilm

Scar incased in PTFE sleeve

Tubing kink

Connector failure

Approach to repair of an uninfected implant

CHAPTER 12 Postoperative Considerations II

Penile necrosis




CHAPTER 13 IPP & Corporal Fibrosis


Etiology of corporal fibrosis

Surgical strategies in fibrosis

Other strategies for fibrosis

Does length matter? Strategies to maximize it

CHAPTER 14 IPP and Peyronie’s Disease 169


Specific features of prosthetic Surgery in Peyronie’s disease

Surgical algorithm

Residual curvature correction after penile prosthesis implantation

Lengthening procedures in Peyronie’s Disease

Complications related to penile prosthesis in the Peyronie’s population

Postoperative rehabilitation

Satisfaction outcomes after penile prosthesis in Peyronie’s population

CHAPTER 15 Redo Penile Prosthesis Implantation for Mechanical Failure


Causes of penile prosthesis failure


Tips and tricks in redo penile implant surgery for mechanical failure

CHAPTER 16 Penile Implants and Priapism

Clinical features of priapism


Immediate penile prosthesis placement

Penile prosthesis with severe corporal fibrosis

CHAPTER 17 IPP in neophallus


Use of prosthetic implants in the neophallus

Principles of penile prosthesis insertion in the neophallus

Preoperative considerations

Operative / intra‑op

Postoperative care

Functional outcomes


Device survival

Explantation for infection or erosion

Revision surgery

CHAPTER 18 Building an IPP Practice & Peri‑Procedural Counseling to Optimize Patient Satisfaction

Building an IPP practice

Peri‑procedural counseling to optimize patient satisfaction

Final thoughts on optimizing a high‑volume IPP clinic from Dr. Köhler

Final thoughts on optimizing a high‑volume IPP clinic from Dr. Wilson

SECTION III Urinary Incontinence: Artificial Urinary Sphincter (AUS) and Sling

CHAPTER 19 Urinary Incontinence (AUS). Preoperative Assessment (Standard and Troubleshooting)

Initial evaluation

Challenging stuations

Revision surgery

CHAPTER 20 Basic Perineal & Scrotal Techniques



Surgical procedure

Comparison of the different approaches

CHAPTER 21 AMS 800 Prosthesis ‑ Intraoperative Management


Foley catheter

Incisions – retractors

Double versus single cuff

Cuff sites

Measuring for cuff sizing

Urethral dissection

Urethral injury

Transcorporal (TC) cuff with or without penile implant

Urethral wrap

Hydraulic testing

Choice of reservoir pressure

Reservoir placement – Inguinal, midline, ectopic

Reservoir filling – technique, volume

Pump placement

Routing of tubing

Wound closure – Dressing

Urethral catheter removal

CHAPTER 22 Artificial Urinary Sphincter (AUS) Postoperative Considerations

Initial deactivation (6 – 8 weeks)


Urinary retention

Wound separation

Early device infection

Subsequent post‑operative period

Late complications

Risk factors

Device information card and medic alert

Management of situations after recovery is complete

Other conditions that complicate artificial sphincter use and longevity

Concern about the pressure‑regulating balloon location

CHAPTER 23 Artificial Urinary Sphincters (AMS 800®, Boston Scientific, MA, USA) in Women

History of the prosthesis and its use in women

Indication and counterindications

The AMS 800® device in neurogenic patients

Surgical procedure


Categorías: ,


This textbook gives comprehensive coverage to the surgical management of erectile dysfunction with penile prostheses (PP) and the management of stress urinary incontinence using bladder outflow resistance created by the artificial urinary sphincter (AUS). Its intended audience are urologists who are interested in one or both topics.

The text is divided into 3 sections.

The first one deals with the history of the development of PP and the AUS, the surgical anatomy related to male erectile function and male and female urinary incontinence, operating room logistics for PP surgery, and the steps in setting up a dedicated urologic prosthetic practice.

The second part is devoted to restoring erectile function using PP. It includes chapters dealing with the appropriate evaluation of the surgical candidate, techniques of implant placement by various incisions, management of the patient postoperatively including addressing complications, and the use of PP in special circumstances including priapism, Peyronie’s Disease, fibrotic corporal bodies and the neophallus. The section concludes with a chapter on building a prosthetic urology practice, periprocedural counseling, and optimizing patient and partner satisfaction.

The third segment compromises with the AUS including evaluating patient candidates, basic scrotal and perineal placement techniques, intraoperative and postoperative management of the patient and any complications which may develop.

A final chapter deals with the use of the AUS in women.

Información adicional


Enrique Lledó García, ESSM – European Society for Sexual Medicine, Ignacio Moncada Iribarren, John Mulcahy, Juan Ignacio Martínez Salamanca



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