The Perito Implant™ is Dr. Paul Perito’s minimally invasive infrapubic approach to three-piece inflatable penile implant placement.
Dr. Perito first described the technique in his 2008 Journal of Sexual Medicine paper, “Surgical Techniques: Minimally Invasive Infrapubic Inflatable Penile Implant.” The technique was developed to streamline penile implant surgeries to be as efficient as possible.
What Is the Perito Implant™ Technique?
While penile implant surgery can be performed via multiple approaches, the two most commonly used for inflatable penile prostheses are the penoscrotal approach and the infrapubic approach.
The penoscrotal approach is performed through an incision where the penis meets the scrotum. The infrapubic approach, preferred by Dr. Perito, is performed immediately above the base of the penis, and is incorporated into the Perito Implant™ Technique. This provides access for placement of the components of a three-piece inflatable penile prosthesis while avoiding a primary surgical incision through the scrotum.
Dr. Perito has played a major role in the refinement, standardization, and widespread teaching of the modern minimally invasive infrapubic technique. Comparative research has also associated minimally invasive infrapubic implantation with shorter operative times and earlier return to sexual activity than the penoscrotal approach.
In 2008, Dr. Perito published “Surgical Techniques: Minimally Invasive Infrapubic Inflatable Penile Implant” in The Journal of Sexual Medicine. The paper describes a systematic surgical procedure designed to minimize operative steps and improve efficiency during implantation.
The historical development and subsequent refinements of modern infrapubic implantation are also discussed in “Nuances of infrapubic incision for inflatable penile prosthesis,” published in the International Journal of Impotence Research, also co-authored by Dr. Perito.
The objective is not simply to perform the surgery quickly; standardization is intended to eliminate unnecessary operative steps and create a consistent, reproducible surgical process.
How Long Does the Procedure Take?
One characteristic closely associated with the Perito Implant™ Technique is its operative efficiency. In uncomplicated primary penile implant cases, Dr. Perito’s highly standardized approach may allow surgery to be completed in approximately 15 minutes.
This, however, should not be seen as a guaranteed surgical time for every patient. Revision surgery, significant scar tissue, Peyronie’s disease, previous pelvic procedures, unusual anatomy, or other clinical factors can make the procedure time significantly longer.
Why Surgeon Experience Matters
Penile prosthesis implantation is a specialized area of urologic surgery and thus requires extensive training.
Successful implantation involves more than making an incision and positioning a device: The surgeon must evaluate anatomy, select and size the prosthesis appropriately, place the cylinders, position the pump and reservoir, minimize infection risk, recognize scar tissue or anatomical abnormalities, and manage unexpected findings during surgery.
For patients considering a penile prosthesis, both the device and the experience of the surgeon performing the procedure deserve consideration.
“Choosing an experienced implant surgeon is one of the most important decisions a patient makes when considering penile prosthesis surgery,” says Dr. Perito.
Considering Penile Implant Surgery?
Choosing a penile implant involves more than selecting a prosthetic device.
The surgeon’s experience, surgical approach, implant selection, anatomy, previous treatments, medical history, and individual goals can all affect the treatment plan.
Patients considering penile implant surgery at Perito Urology can schedule a consultation with Dr. Paul Perito to discuss available implant options, the Perito Implant™ Technique, expected recovery, and whether penile prosthesis surgery is appropriate for their circumstances.
Dr. Perito’s Published Research on the Technique
The Perito minimally invasive infrapubic penile implant placement technique has been described and reviewed in peer-reviewed medical literature.
Minimally Invasive Infrapubic Inflatable Penile Implant
Perito PE.
“Surgical Techniques: Minimally Invasive Infrapubic Inflatable Penile Implant.”
The Journal of Sexual Medicine. 2008;5(1):27–30.
This publication describes Dr. Perito’s minimally invasive infrapubic surgical technique and the operative steps developed to improve efficiency during penile prosthesis implantation.
The Infrapubic Surgical Approach
Vollstedt A, Gross MS, Antonini G, Perito PE.
“The infrapubic surgical approach for inflatable penile prosthesis placement.” Translational Andrology and Urology. 2017;6(4):620–627.
This review discusses the history of infrapubic penile implant surgery, Dr. Perito’s surgical approach, patient selection, postoperative care, and potential complications.
Nuances of Infrapubic Implantation
Perito PE, Mulcahy J, Wen L, Wilson SK.
“Nuances of infrapubic incision for inflatable penile prosthesis.”
International Journal of Impotence Research. 2022;34:524–533.
This review examines the development of infrapubic implantation and technical refinements associated with modern infrapubic penile prosthesis surgery.