I attended as a Faculty and Participant in the Live International Workshop on Penile Prosthesis in Bangalore, India on 21 November 2019. Being the largest volume penile implant surgeon in north India, I got the opportunity to share my data with the other elite panellists.
The workshop was a wonderful collaborative effort by the ISSM (International Society of Sexual Medicine) and the South Asian Society of Sexual medicine (SASSM).
The workshop was powered by Boston Scientific India. It was an exclusive event with the best of the best penile prosthesis surgeons collaborating on improving the penile implant business in India.
The key international speakers at the pre workshop seminars were Dr Salamanca and Dr Ignacio Moncada from Lyx Urologia Spain. Dr Guillio Graffa from UK also shared his experiences building the business in the UK.
The workshop not only refreshed key concepts of penile implantation but also the livid debates and discussions improved on current understanding and settled recent controversies in penile prosthesis.
Dr Salamanca 
Dr Garaffa 
Dr Moncada
Key Debates during the workshop
There were many important topics debated by national and international faculty. Some important ones are here.
Debate 1 – Antibiotic coated vs Non coated implants and infection rates
Dr Moncada is a big fan of antibiotic coated inflatables. He loves the Inhibizone. But by default prosthesis available in India are not coated. We indian implanters usually dip the implants in gentamycin before use.
My implant infection rates are below 0.1 percent. Even without the use of Inhibizone. The international panellists were surprised. But every single serious penile implant surgeon in India presented similar data. I think it is time to review the antibiotic coating and its benefits.
Debate 2 – Sizing of malleables – Oversize or Undersize
Dr Garaffa talked about over sizing malleables leads to erosions. I contended that under sizing can lead to a floppy erection. I was seconded by Dr Rupin Shah who also prefers to put in a over sized snug implant. The advantage is that the implant stays rigid ad loosening anyways happens in a few months. The Tactra is a good implant to test this hypothesis with.
Debate 3 – Placement of reservoirs – Ectopic vs Traditional
Reservoir placement has always been a ore issue. New implanters tend to place the reservoir ectopically. But purists still swear by the retzius space placement.
I have found that ectopic placed reservoirs tend to migrate or herniate. The international faculty also agreed. Any serious implanter should get his reservoir placement correct from day 1.
Debate 4 – Dr Perito and his infrapubic and Dr Valenzuela and his Subcoronal
I have been trained by Dr Park and Dr Valenzuela. So the sub coronal penile prosthesis placement is close to my heart. Though my maximum volume now is by the penoscrotal approach.
I have never liked the infrapubic approach. But in my patients looking for girth and length enhancement I sometimes will use the infrapubic also.
None of the international faculty like the Infrapubic of Dr Perito. Dr Perito and Coloplast. Are you listening ? And by the way I am a huge fan of Dr Perito.
The Hustle during the debate
