suprapubic fat pad excision with simultaneous placement of ...€¦ · suprapubic fat pad excision...
TRANSCRIPT
![Page 1: Suprapubic Fat Pad Excision with Simultaneous Placement of ...€¦ · Suprapubic Fat Pad Excision with Simultaneous Placement of Inflatable Penile Prosthesis Adam S. Baumgarten1,](https://reader031.vdocuments.site/reader031/viewer/2022013023/6037b8fcfdb0c922526edb0f/html5/thumbnails/1.jpg)
Suprapubic Fat Pad Excision with
Simultaneous Placement of Inflatable
Penile Prosthesis
Adam S. Baumgarten1, Jonathan A. Beilan1, Bhavik B. Shah1, Jared J. Wallen, Michael Bickell1,Justin Parker, Gerard D. Henry2,
Rafael E. Carrion1
1University of South Florida; Tampa, FL2Regional Urology; Shreveport, LA
![Page 2: Suprapubic Fat Pad Excision with Simultaneous Placement of ...€¦ · Suprapubic Fat Pad Excision with Simultaneous Placement of Inflatable Penile Prosthesis Adam S. Baumgarten1,](https://reader031.vdocuments.site/reader031/viewer/2022013023/6037b8fcfdb0c922526edb0f/html5/thumbnails/2.jpg)
Disclosure
Nothing to disclose
![Page 3: Suprapubic Fat Pad Excision with Simultaneous Placement of ...€¦ · Suprapubic Fat Pad Excision with Simultaneous Placement of Inflatable Penile Prosthesis Adam S. Baumgarten1,](https://reader031.vdocuments.site/reader031/viewer/2022013023/6037b8fcfdb0c922526edb0f/html5/thumbnails/3.jpg)
Objective
Many men suffering from erectile dysfunction are
overweight and have generous suprapubic fat
pads
Suprapubic fat pads can contribute to decreased
visible exophytic phallic length
We describe a novel surgical concept of
suprapubic fat pad excision with concomitant
placement of inflatable penile prosthesis
![Page 4: Suprapubic Fat Pad Excision with Simultaneous Placement of ...€¦ · Suprapubic Fat Pad Excision with Simultaneous Placement of Inflatable Penile Prosthesis Adam S. Baumgarten1,](https://reader031.vdocuments.site/reader031/viewer/2022013023/6037b8fcfdb0c922526edb0f/html5/thumbnails/4.jpg)
Ideal Patient
• Overweight with
large suprapubic fat
pad
• Decreased
exophytic phallic
length
• “Double belly” sign
![Page 5: Suprapubic Fat Pad Excision with Simultaneous Placement of ...€¦ · Suprapubic Fat Pad Excision with Simultaneous Placement of Inflatable Penile Prosthesis Adam S. Baumgarten1,](https://reader031.vdocuments.site/reader031/viewer/2022013023/6037b8fcfdb0c922526edb0f/html5/thumbnails/5.jpg)
“Double Belly” Sign
![Page 6: Suprapubic Fat Pad Excision with Simultaneous Placement of ...€¦ · Suprapubic Fat Pad Excision with Simultaneous Placement of Inflatable Penile Prosthesis Adam S. Baumgarten1,](https://reader031.vdocuments.site/reader031/viewer/2022013023/6037b8fcfdb0c922526edb0f/html5/thumbnails/6.jpg)
Technique
Incision is made 2 cm inferior and medial to the
ASIS and carried across the infrapubic region in
a curvilinear fashion
Passes one finger breath above the base of the
penis
Dissection is carried down to anterior abdominal
fascia, and fat pad is excised
Suspensory ligament can be released
![Page 7: Suprapubic Fat Pad Excision with Simultaneous Placement of ...€¦ · Suprapubic Fat Pad Excision with Simultaneous Placement of Inflatable Penile Prosthesis Adam S. Baumgarten1,](https://reader031.vdocuments.site/reader031/viewer/2022013023/6037b8fcfdb0c922526edb0f/html5/thumbnails/7.jpg)
Fat Pad Excision
![Page 8: Suprapubic Fat Pad Excision with Simultaneous Placement of ...€¦ · Suprapubic Fat Pad Excision with Simultaneous Placement of Inflatable Penile Prosthesis Adam S. Baumgarten1,](https://reader031.vdocuments.site/reader031/viewer/2022013023/6037b8fcfdb0c922526edb0f/html5/thumbnails/8.jpg)
Technique
IPP placed via same incision similar to infrapubic
approach
2 JP drains are placed prior to closure
![Page 9: Suprapubic Fat Pad Excision with Simultaneous Placement of ...€¦ · Suprapubic Fat Pad Excision with Simultaneous Placement of Inflatable Penile Prosthesis Adam S. Baumgarten1,](https://reader031.vdocuments.site/reader031/viewer/2022013023/6037b8fcfdb0c922526edb0f/html5/thumbnails/9.jpg)
Results
8 patients underwent suprapubic fat pad excision with
simultaneous placement of IPP
Mean BMI was 36.1
At last follow up, all patients have excellent cosmetic and
functional outcomes
No known complications have occurred secondary to the fat
pad excision in our cohort
![Page 10: Suprapubic Fat Pad Excision with Simultaneous Placement of ...€¦ · Suprapubic Fat Pad Excision with Simultaneous Placement of Inflatable Penile Prosthesis Adam S. Baumgarten1,](https://reader031.vdocuments.site/reader031/viewer/2022013023/6037b8fcfdb0c922526edb0f/html5/thumbnails/10.jpg)
Before and After
![Page 11: Suprapubic Fat Pad Excision with Simultaneous Placement of ...€¦ · Suprapubic Fat Pad Excision with Simultaneous Placement of Inflatable Penile Prosthesis Adam S. Baumgarten1,](https://reader031.vdocuments.site/reader031/viewer/2022013023/6037b8fcfdb0c922526edb0f/html5/thumbnails/11.jpg)
Before and After
![Page 12: Suprapubic Fat Pad Excision with Simultaneous Placement of ...€¦ · Suprapubic Fat Pad Excision with Simultaneous Placement of Inflatable Penile Prosthesis Adam S. Baumgarten1,](https://reader031.vdocuments.site/reader031/viewer/2022013023/6037b8fcfdb0c922526edb0f/html5/thumbnails/12.jpg)
Conclusions
Suprapubic fat pad excision is a safe and
reproducible technique that can be performed
simultaneously with placement of IPP in appropriately
selected patients
Can lead to higher patient satisfaction, enhanced
sexual performance, and improved quality of life