1867 COMPARISON OF CONCEAL RESERVOIR TO REGULAR RESERVOIR PLACEMENT FOR HIGH RISK PATIENTS RECEIVING INFLATABLE PENILE PROSTHESIS IMPLANTATION

Abstract

INTRODUCTION AND OBJECTIVES: Conceal Reservoir is a new design to facilitate ease of inflatable penile prosthesis (IPP) implantation. Placement of a reservoir in a patient with multiple lower abdominal/pelvic surgeries is a challenge in prosthetic surgery. METHODS: This study is to compare the sub Scarpa’s facia placement of Conceal versus regular reservoir in high risk patients. The 3 piece IPP implantation was performed through either a peno scrotal or an infra pubic incision. During placement of reservoir, the rectus facia or the external oblique aponeurosis/muscle at the external inguinal ring was identified. A space was created in the sub Scarpa’s facia towards the ipsilateral shoulder in either the right or the left lower abdomen for the reservoir placement. RESULTS: From January, 2007 to November, 2010 a total of 261 penile prosthetic surgeries were performed at the MD Anderson Cancer Center. Of those 261 surgeries, 18 patients received the sub Scarpa’s facia placement of the regular reservoirs (12 patients) and Conceal Reservoirs (6 patients). Among these 18 patients, 8 men had a history of radical cystectomy with either Studer neobladder or ileoconduit urinary diversion. Five patients had a prior history of colon cancer surgery with colostomy or colostomy take down. Four patients had large pelvic scarcoma resection and one man had history of bowel necrosis with multiple abdominal surgeries. No patient complained of any discomfort at the reservoir area or reported auto inflation at the follow up. The palpable reservoirs were seen in 5 patients who received regular reservoirs, but none in patients with Conceal Reservoir. CONCLUSIONS: Both regular and Conceal Reservoir placements in Sub Scarpa’s facia are a safe and effective in high risk patients. However, the conceal reservoir is cosmetically more acceptable.