For Part One of this interview, click here.
InformatioNation Blog: Welcome back, Dr. Paul E. Perito. When we left off, you were just about to explain the cylinder placement process. Can you do that now?
Dr. Paul E. Perito: When placing the cylinders, the stay sutures act as my retractor-less retractor; one simply needs to tell your assistant to pull on the blue or pull on the clear and this eases the placement of the cylinder.
InformatioNation Blog: Do you use RTEs?
Dr. Paul E. Perito: I rarely use rear tip extenders greater than 1 cm so that the axial strength of the erection falls on the cylinder itself. Also, by minimizing the use of RTEs, there is a more physiologic erection with no hinging effect.
InformatioNation Blog: You again utilize the artificial erection here, via rapid inflation. What does that accomplish?
Dr. Paul E. Perito: The rapid inflation allows me to check both the functional and the cosmetic result of the implant. I can make sure that the cylinders are in the mid-glands, that they are in the proper position. It also assists in seeding the implant proximally. If there’s any modeling that needs to be performed, it can be performed at this time.
InformatioNation Blog: What size reservoir do you use?
Dr. Paul E. Perito: I use reservoirs appropriate for the patient. With any of the larger implants, I choose to leave some fluid in their cylinder so the patient does not need to fill the implant with an inordinate amount of effort.
InformatioNation Blog: And the pump, where do you prefer it to reside?.
Dr. Paul E. Perito: The pump is placed in the most dependent portion of the scrotum, with its final position being achieved by gently pulling down on the pump thus releasing the dartos fascia making it easy for a right or left handed patient to operate.
InformatioNation Blog: How do you decrease the incidence of redundant tubing in the infrapubic area?
Dr. Paul E. Perito: The pump is pulled up to mid-scrotum prior to making the connections. This also makes the connections easier for those with big fingers. Once the connection is made, the pump is returned to the most dependent portion of the scrotum, thus disposing of any of the redundant tubing.
InformatioNation Blog: And the drain?
Dr. Paul E. Perito: The drain is placed in a separate stab wound; and we drain the entire wound running from the scrotum all the way up to the infrapubic area. It should be noted that everyone receives a 10-pound sandbag right on the infrapubic area in the recovery room, which is usually left in place for two hours all designed to diminish the amount of post operative swelling.
InformatioNation Blog: Any final words?
Dr. Paul E. Perito: This minimally invasive penile implant procedure is an easily reproducible, safe and efficacious alternative to traditional penile implant placement procedures. I appreciate your allowing me to speak with you today.
InformatioNation Blog: Thank you.
Dr. Paul E. Perito graduated the University Of Maryland School Of Medicine in 1988. His Coral Gables, Florida, urology center, Perito Urology, draws patients from around the globe for its innovative and updated Erectile Dysfunction treatments. Having successfully performed over 3,000 penile implants since 2005, Dr. Paul E. Perito is considered a leader in the field. His signature minimally invasive technique, The Perito Approach, has been taught to surgeons worldwide through travel and at Coral Gables Hospital, where he is Director of Urology. Dr. Paul E Perito has participated in countless medical studies in his quest to simplify the penile implant process and make the procedure safer for his patients.
The information contained in this article is provided by Dr. Paul E. Perito for educational purposes only. It is not intended to treat or diagnose any condition.