Hi,
@Lipzz17 and thanks for the excellent questions.
I would like to know whether Dr Carney performs penile PMMA injections in patients who have an inflatable penile prosthesis (IPP), specifically a Coloplast Titan.
While Dr. Carney
can perform non-surgical girth enhancement on a penis that has had an IPP implanted, he does not recommend it. Once an IPP is placed, it essentially destroys the surrounding tissue. So while you technically can add girth using fillers, it takes a lot longer because you have to be extremely slow and careful in your injection technique in order to preserve the form and function of the organ, and the healing process is much slower than with a penis that has not had an IPP implanted. You can imagine it as if the skin of the penis and the underlying tissues now behave more like wet tissue paper. Additionally, if there are any major complications after PMMA, such as severe granuloma or prolonged inflammation/pain, the correction would require degloving of the penis, which becomes virtually impossible once an IPP has been placed.
The prosthesis is implanted inside the corpora cavernosa. Do you consider patients with an IPP suitable candidates for penile PMMA treatment? Do you have experience treating patients with an inflatable penile prosthesis?
No, not unless they have first had a foundation of HA successfully placed and healed. However, again, it's not something we recommend. Yes, Morganstern-Rejuvall is the first urology-based men's sexual health clinic in the US. Our entire team has extensive experience treating patients with an IPP, and Dr. Morganstern was involved in the development of the very first IPP in existence.
Before the procedure, do you perform an ultrasound or any other imaging exam to map the exact location and depth of the prosthesis components and surrounding tissues?
No. Dr. Carney is a reconstructive and trauma urologic surgeon with over 4 decades of experience and has performed 1000s of complex operations on the penis and genitourinary region in men. Because of his extensive hands-on experience with penile anatomy, he is able to know where everything is just by touch.
If you do perform PMMA in patients with an IPP, what specific precautions or injection techniques do you use to avoid contact with or damage to the prosthesis?
There is no risk of touching the IPP because the needle does not go that deep during the non-surgical girth enhancement procedure. Additionally, again, Dr. Carney is a reconstructive urologic trauma surgeon with over 4 decades of experience. He is able to know where the implant and all important penile structures and tissues are and how to maintain proper function of the organ due to his extensive training, experience, and leadership in the field.
