“There is no doubt that the expediency of the procedure dramatically reduces the incidence of complications. I believe that by limiting my dissection of the fragile and essential spongy tissues of the penis, my surgical outcomes are superior to other techniques.” – Dr. Paul E. Perito
The Perito Minimally Invasive Penile Implant Technique
Dr. Perito developed this innovative new procedure after more than ten years of operative experience with penile implantation. Dr. Perito routinely completes the procedure in less than fifteen minutes, depending on the anatomical aspects of each patient.
Dr. Perito training other surgeons
Through this procedure, Dr. Perito is able to completely restore sexual function via minimal incisions and time “on the table.” In this approach, the implant is inserted through a small incision above the penis. These small incisions heal quickly and most patients can resume normal sexual activity four to six weeks after the procedure. After completing more than 3,000Minimally Invasive Penile Implants, Perito Urology is considered one of the top centers in the world for the treatment of erectile dysfunction.
[more about penile implants]
As a highly skilled surgical urologist, Dr. Perito performs a number of other important procedures, including treatments related to:
- Urinary incontinence
- Peyronie’s Disease
- Testicular implants
Intra-facial Placement of the Penile Prosthesis Reservoir: A Novel Technique for the High Risk Patient
Paul Perito, MD1; Omar Pacha, BS2; Mohit Khera, MD, MBA2
1Coral Gables Hospital, Miami, FL
2Baylor College of Medicine, Houston, TX
Presented at the 2009 Sexual Medicine Society of North America Conference
Bowel or bladder injury during placement of a penile prosthesis reservoir can be a devastating complication. Certain patients, such as cystectomy patients or those with multiple abdominal surgeries, are known to be much more susceptible to this complication. In this study we examine a novel technique of an intra-facial placement of the penile prosthesis reservoir to mitigate the risk of bowel or bladder injury.
[download full abstract]
For those of you interested in seeing what one of the minimally invasive penile implant devices I designed looks like, I’ve posted a photo example of the Titan OTR Inflatable Penile Implant below. It is one of the most safe, effective and widely-used penile implants to date. It’s manufactured by Coloplast Corporation and I use it often when performing surgical implants.
Sometimes the only way to overcome erectile dysfunction is with a penile implant. Today’s implants are truly advanced medical devices, offering a safe and efficacious option for men to resume a normal, spontaneous sex life.
A penile implant is a device that is placed into the shaft of a man’s penis, which provides consistent erections through a saline pump mechanism (inflatable implant) or manual positioning (malleable implant). The implant does not make the penis larger; it only allows it to function again. Also, the implant does not change the way a man urinates or ejaculates.
Inflatable Penile Implant: Coloplast Titan® and Titan OTR
The Coloplast Titan OTR implant is a three-piece device made of Bioflex®, a biopolymer material, and filled with sterile saline (salt water) fluid. The device operates by shifting fluid from one part of the implant to another in order to make the penis erect.[learn more]
Malleable Penile Implant: Coloplast Genesis®
The malleable penile implant consists of two malleable rods. The rods are implanted in the chambers of the penis. When an erection is desired the patient positions the penis into an erect state. When the erection is no longer desired, the patient returns the penis to its original flaccid-like position. [learn more]
Situated in the heart of beautiful Coral Gables, Florida, Perito Urology’s concierge care redefines what a men’s health practice should be. Every day, patients from across the United States and around the globe visit us to receive excellent care while enjoying the unique attractions of our tropical location.
The Perito Urology Team
The Perito Urology staff team is wholly dedicated to providing patients with the best experience possible. We understand the complexity of surgical procedures –physically, mentally, and emotionally – and are uniquely positioned to help patients beyond the reception desk.
[Click here for a list of what to bring.]
If you are coming to Miami from out of town, Perito Urology can assist with:
- Personalized consultation with Dr. Perito in advance of your trip, which includes a discussion of what to bring and what to expect.
- Assistance with questions regarding medical insurance/reimbursement.
- Hotel recommendations and booking assistance
- Restaurant recommendations and reservations.
- Car service to and from Miami International Airport, Perito Urology, and Coral Gables Hospital.
- Personalized post-operative meeting with Dr. Perito prior to your departure.
Typically our out of town patients will arrive the day before surgery and undergo a complete evaluation by Dr. Perito and staff on the day they arrive. The patient will undergo surgery the following morning and remain in the hospital for 23 hours. Patients are asked to remain in town for at least 48 hours more in order for Dr. Perito to re-examine them and convey the appropriate discharge instructions.
About Coral Gables Hospital
All surgical procedures are performed at Coral Gables Hospital. Established in 1927, it is a 256-bed hospital that serves Coral Gables, Coconut Grove, South Miami, South Miami-Dade, and Kendall.
“Paul is a true pioneer in this field; he has managed to make a 30-year-old procedure better, maximizing time efficiency of all steps. Paul is a creative and excellent teacher.”
–Dr. Irwin Goldstein, MD
Dr. Paul Perito performs more penile implant surgeries than any other surgeon, approximately 500 procedures per year. Since starting his practice in 2005, Dr. Perito has completed more than 3,000 penile implant procedures, making Perito Urology one of the top centers in the world for the treatment of erectile dysfunction.
Among his many publications, Dr. Perito has written extensively on a number of important topics, including penile implantation under local anesthesia and new techniques to avoid infection during the penile implant procedure. Dr. Perito is an active member of the American Urological Association and the Society of Prosthetic Surgeons; networks that have helped him establish a training program for surgeons desiring to learn his minimally invasive technique.
THE MINIMALLY INVASIVE INFRAPUBIC INFLATABLE PENILE PROSTHESIS: A 1000- PATIENT REVIEW Paul E. Perito, MD FACS, Jose Guerra, MD, Anna Moscowitz, (Miami, FL) Presented at the 2009 Sexual Medicine Society of North America Conference
Objective: To further describe and illustrate a simplified approach for the infra-pubic inflatable (three-piece) penile prosthesis and review its efficacy, post-operative morbidity, and resultant patient return to function.
Methods: Retrospective review of N = 1098 inflatable penile prostheses implanted from January 2002 to May 2009. All IPP’s were Coloplast Titan (previously Mentor) three-piece penile prostheses implanted by one surgeon. 931 patients were original implants (84%), 138 revisions (13%) and 29 reimplants (3%). Nearly all patients received similar pre- and intra- operative antibiotic prophylaxis (flouroquinolone and hibiclens 24-hours before the procedure and Vancomycin and Gentamycin preoperatively). Modifications to the previously presented (SMSNA 12/07) Minimally Invasive approach include: patients are no longer catheterized, only 60cc reservoirs are utilized and there is no dilation of the corpora beyond use of an artificial erection. All patients receive a #7 JP drain (removed the following day). Patient follow-ups were reviewed postoperatively for six-weeks. All immediate and delayed complications were reported.
Results: The Minimally Invasive (Perito Penile Implant) technique was easily reproduced in 624 (67%) virgin cases. The remaining 307(33%) virgin cases required ancillary techniques to achieve implantation (i.e. Modeling). All revisions cases were conducted via infra-pubic technique regardless of initial approach. Ten infections (.91%) occurred and two were successfully salvaged. Two urethral injuries occurred distally and were repaired primarily. Two patients presented with significant scrotal hematoma and required drainage. No patients experienced glandular anesthesia or hypoesthesia after six-weeks. 901 (82%) of patients were instructed to resume sexual function at four-weeks and all remaining patients were instructed by six-weeks.
Conclusion: The Minimally Invasive (Perito Implant) infra-pubic penile prosthesis implantation is safe, efficacious and offers patients a rapid return to sexual function. Post-operative outcomes mirror clinical literature of other approaches.
Another implant option for men who are interested in having the minimally invasive penile implant surgery is the Genesis Flexible Rod penile implant. This patented medical device is manufactured by Coloplast Corporation and is one of the more effective options aside from the Titan OTR inflatable implant. The malleable penile implant consists of two malleable rods. The rods are implanted in the chambers of the penis. When an erection is desired the patient positions the penis into an erect state. When the erection is no longer desired, the patient returns the penis to its original flaccid-like position.
Below is a biological drawing of the device.
Here is a patient testimonial from Alfredo, who highlights how the Perito minimally invasive penile implant procedure changed his life for the better!