The Dual‐Surgeon Approach for Penile Prosthesis Surgery: A Case Series Highlighting Benefits of This Novel Approach

OBJECTIVE: To assess the outcomes of a dual-surgeon approach to inflatable penile prosthesis (IPP) surgery, where two non-fellowship-trained urologists partnered to perform these procedures following intensive proctoring by an international expert. PATIENTS AND METHODS: A retrospective analysis of patients who underwent 'dual-surgeon' IPP surgery over a 10-year period between August 2008 and July 2018 was performed. Data on patient demographics, peri-operative parameters, complications (Clavien-Dindo system), rate of prosthesis failure, and the necessity of revision surgery were extracted, analysed and compared to published outcomes from high volume institutions. RESULTS: A total of 175 patients underwent IPP surgery over a 10-year period. The mean age was 64 years (IQR 59-70), the mean operative time was 65.7 min (range 32-157 min), and the mean length of stay in hospital was 1.6 nights (range 1-6 nights). The majority of patients (90.9%) received a Coloplast Titan Implant. The overall complication rate was 22.2% (38/175). Notably, there were no complications > Clavein-dindo grade III. Six patients (3.4%) required revision surgery for mechanical failure. CONCLUSIONS: Dual surgeons performing IPP after intensive training from visiting international experts can achieve comparable outcomes to high volume local and international centres. This strategy of dual-surgeon collaboration should be considered in low volume implanters with no prior fellowship training in prosthetic urology.