Lessons learned from 25 years of prosthetic surgery

Every year 50,000 penile implant surgeries are performed worldwide. More than 75% of these cases are done by surgeons doing very few implants; i.e., less than 4 cases a year, and it is well known that surgeons doing higher volumes have better outcomes. However, establishing a successful penile implant center relies on more than just the performing surgeon: a multi-disciplinary medical and paramedical team is of utmost importance. Besides this, standardized work up is required and includes integration of the couple, using questionnaires, sharing all possible information/sources with the patient and partner, etc. The implant surgeon should be careful not to create unrealistic expectations in the couple. Additionally, since this type of surgery is a very technical and multi-modal intervention, a fast track method is indispensable. To achieve this, well-trained teams in the patient ward, operation room, and consultation department are essential. Even those surgeons who consider themselves expert in penile implant surgery can improve their outcomes by attending master classes for expert implanters, and by reassessing their own surgical procedures.