(182) MALLEABLE PENILE PROSTHESIS IMPLANTATION UNDER LOCAL ANESTHESIA: SURGICAL TECHNIQUE AND EARLY EXPERIENCE

Abstract Introduction Penile prosthesis (PP) is the gold-standard therapy for medication-refractory erectile dysfunction (ED) and traditionally is performed under general anesthesia. Subcoronal malleable penile prosthesis (MPP) implantation, which requires minimal dissection, can be performed under local anesthesia, particularly in patients with risk factors for general anesthesia, on anticoagulation therapy or antiplatelet therapy, or with a preference for local anesthesia. Objective We propose a technique of MPP implantation under local anesthesia and present two cases performed at our institution. Methods The surgical technique and details of the clinical cases are demonstrated in the video. Both patients received pre-operative analgesia with or without anxiolytic oral medication, an intra-operative block, and post-operative analgesia for two weeks. At 3-month and 1 month postoperative follow-up, respectively, both patients reported satisfactory results. Results The surgical technique and details of the clinical cases are demonstrated in the video. Both patients received pre-operative analgesia with or without anxiolytic oral medication, an intra-operative block, and post-operative analgesia for two weeks. At 3-month and 1 month postoperative follow-up, respectively, both patients reported satisfactory results. Conclusions MPP implantation under local anesthesia is a viable and safe option for patients who are unable or unwilling to undergo general anesthesia. Cessation of anticoagulation is not required via the subcoronal approach, and patients can reliably be discharged the same day without risks related to general anesthesia. A larger cohort and multi-center adaptation are necessary to fine-tune an optimal protocol for enhancing the patient experience with these cases. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Coloplast, Boston Scientific.