Abstract
BACKGROUND: The Penuma is a soft silicone penile implant designed for cosmetic enhancement of the flaccid penis in men who have normal erections. OBJECTIVES: The goal of this study is to report outcomes on patient satisfaction at least 6 months after Penuma subcutaneous penile implant for cosmetic enhancement of the penis, and to determine if modifications in surgical approach resulted in reduction in postoperative complications. DESIGN: Penile measurements, adverse events, and patient satisfaction were compared between patients undergoing the new lateral scrotal incision versus the traditional infrapubic approach. METHODS: A retrospective chart review was performed on all patients who underwent a Penuma implant by a single surgeon from April 2019 to December 2022. A 26-item non-validated device-specific questionnaire was sent to patients at least 6 months after the date of their initial surgery. RESULTS: A total of 92 cases were performed by a single surgeon. The average increase in flaccid length was 2.5 cm (±2.2), representing a 44% increase (p < 0.01). The average increase in girth was 3.1 cm (±1.8 cm), a 32% change (p < 0.01). Seroma requiring drainage occurred in 12%. 7% of patients required operative revision of the implant. When assessed by surgical approach, the revision rate was significantly higher in infrapubic patients (13% vs 2%, p < 0.05). The implant removal rate was also significantly higher when the infrapubic approach was used (21% vs 6%, p < 0.05). 82% of patients reported being satisfied or very satisfied with their postoperative penile appearance. 75% of patients would undergo surgery again. CONCLUSION: The subcutaneous Penuma penile implant appears to improve satisfaction with regard to the appearance of the penis and is a viable option for men who desire to enhance flaccid penile length and girth. Furthermore, the lateral scrotal surgical approach appears to have a lower postoperative complication rate.