AUA2020 V07-12: V07-12: Development of a High Fidelity 3-piece Inflatable Penile Prosthetic (IPP) model using 3D-Printing and Hydrogel Molding

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Patrick Saba, Rachel Melnyk, Michael Witthaus*, Gareth Warren, Divya Ajay, Alexander Cranwell, Rochester, NY, Ricardo Munarriz, Boston, MA, Ahmed Ghazi, Rochester, NY

INTRODUCTION

This video demonstrates a high-fidelity, anatomical, full procedural simulation for placement of a 3-piece IPP.

METHODS

Anatomical penile models consisting of a male pelvis, penis, urethra, corporal bodies, inguinal canals, iliac vessels and relevant adjacent structures were created using 3D-printed injection molds. The molds are filled with a poly-vinyl alcohol, a hydrogel that can be modified to replicate realistic tissue consistency. Relevant procedural steps: corporal exposure, dilation, measurement, scrotal pump placement, reservoir placement, prosthesis assembly and closure can be simulated using both an infrapubic or penoscrotal approach. The model has the ability to detect surgical errors including perforation of corpora during dilation, damage to iliac vessels or urethra and improper prosthesis placement. Twelve surgeons: three experts (greater than 250 caseload), three low volume faculty (greater than 50 caseload) and six novices (residents), completed an IPP insertion on the model under operating room conditions, after which a survey assessing realism and usefulness as a training tool was completed.

RESULTS
When compared to live surgery, over 83.3% of the participants agreed that the model realistically replicated the skin retraction, placement of corporal stay sutures, corporotomy, distal dilation, prosthesis measurement, and IPP placement (Figure 1). Skin incision, proximal dilation, reservoir placement, corporal closure and skin closure was found to be realistic in above 66.7% of participants. On average experts agreed that the model could function as a training tool, assessment tool, prerequisite for IPP accreditation, and a requirement prior to live surgery. Experts stated ideally, they would have their trainees complete an average of 3.33 models before live surgical training.

CONCLUSIONS
This video presents a high-fidelity, anatomical, hydrogel simulation platform for 3 piece IPP placement. With the ability to replicate surgical errors, its educational effectiveness as a training tool is further supported. This platform requires no specialized facilities and offers the basis for future male genital reconstruction simulations such as correction of Peyronie’s disease and artificial urinary sphincter insertions.

SOURCE OF FUNDING: None

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