The Tauras 2023 was one of the most innovative events in the field of urology worldwide. The medical community gathered in Italy to learn more about the latest techniques and technologies applied to the specialty. All this was done to bring improvements to patients.
Dr. Paulo Egydio participated in the event. In addition to discovering new developments in the field, he was able to present one of his main contributions to urology: the TEP Strategy (Tunica Expansion Procedure).
Next, find out how Tauras 2023 went, what the main technological advancements in urology were, and learn the details of the TEP Strategy.
What is TAURAS?
Tauras is a congress organized every two years by the University of Turin, located in the north of Italy, in collaboration with the European Society of Urology, the International Society of Urology, the American Urological Association, among others.
The 2023 event represented the fourth edition of Tauras.
Tauras 2023 is intended for physicians working in the urological field, residents in urology and andrology, and students, who were able to follow the program either in person or virtually.
The event’s aim is to offer a theoretical and practical course on innovations involving reconstructive urology, andrology, and robotics, with an emphasis on minimally invasive surgery, preserving sexual function, and improving patients’s quality of life.
Where and when did Tauras 2023 happen?
Over two full days, from June 8 to 10, participants had access to a program that included live surgeries, pre-recorded operations, lectures, case discussions, and debates.
Humanitas Gradenigo Hospital provided all the necessary infrastructure for Tauras 2023.
The importance of Tauras for urology
The event stands out in the world of urology due to its innovative nature.
It seeks to bring participants up-to-date on the most advanced areas of urology, such as reconstructive surgery, andrology, and robotics.
These are also areas with a growing trend. For example, surgeries performed with the support of medical robotics platforms in Brazil increased by 12.5% between 2021 and 2022. Since 2008, there have been more than 100,000 such procedures.
Main themes and news at TAURAS 2023
In 2023, Tauras featured live surgery sessions in two fully connected rooms, hybrid presentations of various procedures, and cutting-edge lectures, discussions, and debates.
The programmed content ranged from procedures like penile prosthesis implants, penile lengthening surgery, multiple incision corporoplasty, inguinal nodule dissection for penile cancer, urinary sphincter implant, anterior and pure arthroplasty, and treatment of ureteral and urethral stenoses with Uventa TM – among many others.
Dr. Paulo Egydio at Tauras 2023
Dr. Paulo Egydio was present at Tauras 2023, not just as a participant eager to learn all the new developments but also to teach.
He was invited to give a virtual lecture on the TEP Strategy (Tunica Expansion Procedure).
Learn more about the TEP Strategy
The TEP Strategy (Tunica Expansion Procedure in English) is a procedure that allows for the placement of a larger and wider implant in a reduced and/or thinned penis after treating fibroses and reconstructing the member.
Dr. Paulo Egydio has been studying geometric principles for over 20 years. They have already been incorporated into the guidelines for the treatment of penile deformities, such as Peyronie’s Disease.
There are seven steps to executing the TEP Strategy, which you will learn next:
Step 1
First, a subcoronal incision is made and the penis is degloved. This allows for the best access to the penile shaft.
Step 2
Then, the neurovascular bundle is dissected. For this, one or two paraurethral incisions are made in Buck’s fascia, with distal preservation.
Once dissected, the bundle is separated from the tunica albuginea, which allows for determining the potential of penile reconstruction.
Step 3
Next, the glans must be held and stretched.
The TEP Strategy uses a mathematical formula to determine the size and distance of the incisions, which should be alternated and no more than 8 millimeters, avoiding the use of grafts. The direction of the cuts should follow the rule: horizontal to recover size and vertical for caliber restoration.
There is no need to elevate the urethra. Just hold and stretch the glans again, to ensure maximum restoration, up to the limit of the nerve bundle and urethra. If the limit is not reached, more horizontal cuts can be added.
Afterwards, the larger cuts need to be sutured.
The TEP Strategy allows for a larger penile prosthesis to be implanted, respecting the anatomy of that member.
Step 4
This is the moment to choose the cylinder size. This decision can only be made once the tissues are reconstructed.
It’s necessary to perform dorsal subterneal tapering to separate the spongy tissue from the tunica albuginea in the larger dorsal compartment.
The cylinders are implanted in the cavernous bodies, and even after this step, new incisions can be made to better accommodate them.
In the case of the inflatable prosthesis, the pump and reservoir must be added without new skin incisions. The small defects generated by the cuts are covered by Buck’s fascia. The cylinders are then inflated to test for axial rigidity and to check for excessive mobility of the glans – which can be corrected with stitches in Dartos’ tunica.
Step 5
To avoid folds, there are three solutions.
The first is intraluminal pressure. As the pressure in the cylinder increases, resistance to folding also increases. The second option is the rate of tissue expansion, and the third is obtaining the best ratio between size and caliber.
Inadequate axial rigidity occurs when there are restrictions in the tunica or within the cavernous bodies, or mechanical-geometric factors with an incorrect ratio of size and caliber, or due to inadequate intraluminal pressure.
Therefore, it is ideal to avoid the use of extenders for the penile prosthesis.
Step 6
In the sixth step, the surgeon will refine the penile geometry with the TEP Strategy.
Thinning is associated with less resistance to folding. Hourglass or indentation cases should be treated with the same strategy of vertical incisions in the affected areas to restore caliber.
Step 7
Finally, it’s time to optimize the axial rigidity of the penis.
For this, the cylinders must be inflated for the rigidity test of the column.
Remember that folds indicate restrictions in the cylinders’ expansion capacity.
If necessary, add new vertical incisions to further expand the tissues and treat restrictions localized in the area of the cylinders.
The simultaneous expansion capacity of the cylinders and tissues prevents folds from occurring, even if there are grafts from previous surgeries.
More information about the TEP Strategy
Patients of Dr. Paulo Egydio who receive the penile prosthesis also undergo the tissue expansion procedure, with the aim of allowing the choice of the largest cylinders for the implant, reducing the need for extenders, and improving the axial rigidity of the penis.
The application of the TEP Strategy allows not only for treating penile deformities – such as curvature, thinning, and loss of size – but also erectile dysfunction, as it provides rigidity to the member.
It’s important to emphasize the need to avoid and resolve folds, as this can only be done intraoperatively. This diagnosis is essential for improving the functionality of the penile prosthesis.
Moreover, for the incisions, it is recommended to avoid crossing them perpendicularly, as the tunica loses resistance.
To learn more about Tauras 2023 or to clarify doubts about the TEP Strategy, do not hesitate to contact us. We are at your disposal.
Read also
- What is penile fracture?
- Surgery for Peyronie’s Disease: Risks and Recommendations
- Egydio’s Technique: Peyronie Disease Treatment
- Does the Egydio Technique Work for Every Penile Curvature?
- Implante de Prótese Peniana | Dr. Paulo Egydio
- Does Small Penis Exist? Check When Size Is a Concern
- 7 Simple Habits to Prevent Prostate Cancer
- Can People with a Penile Prosthesis Play Sports?
- How to Enlarge the Penis: Understanding the Options
- 6 Causes of Penis Fissures: Treatments and Care Tips
