Emerging complications following alternative reservoir placement during inflatable penile prosthesis placement: a 5-year multi-institutional experience.

Abstract

PurposeAlternative, or ectopic, reservoir placement (ARP) has recently gained popularity among prosthetic surgeons in order to avoid injury to pelvic structures during inflatable penile prosthesis (IPP) implantation. However, the true incidence of complications associated with these new techniques remain understudied. We carried out a 5-year multi-center retrospective study with the aim to evaluate complications related to alternative reservoir placement. Materials and MethodsWe retrospectively reviewed databases of IPP surgeries in three institutions from February 2011 to December 2016. The mechanism of failure and complications related to reservoir placement were analyzed. ResultsA total of 974 IPPs were placed in the 5-year period by three surgeons, of which 612 underwent ARP. Mean follow-up to emergence of reservoir-related complications was 20.4 months. There was no significant difference in complication rates between primary and revision cases (p=0.72). A total of 12 cases (2.0%) required revision for reservoir-related complications in the ARP group vs 1.3% in the SOR group (p=0.44). The most common complication in the ARP group was reservoir leakage (N=5). There were three cases that required revision due to abdominal muscular pain. Three Conceal™ reservoir tubing torsions were found that caused blockage of fluid transportation. One reservoir was incidentally found to be intraperitoneal via unrelated imaging. ConclusionsAlternative reservoir placement is a safe and mechanically reliable approach, including among men with prior pelvic surgery. However, there are associated risks which include reservoir leakage, tubing torsion, muscle discomfort and unintended reservoir malposition that may require surgical revision.