Intravesical penile implant reservoir: case report, literature review, and strategies for prevention

Abstract

To present a case of intravesical erosion of an infected multiple-component inflatable penile prosthesis (IPP) reservoir. We retrospectively reviewed a case of complete intravesical erosion of an infected IPP reservoir. We also reviewed the prior urologic literature concerning bladder-related reservoir complications, and formulated potential strategies to prevent these complications in the future. This patient was successfully managed with complete explantation of the cylinders and pump, along with cystotomy, intravesical reservoir removal and cystorraphy. Several months later, he was successfully reimplanted with a multiple-component IPP, and, with 7 months follow-up, has had no further complications. Management of intravesical placement or erosion of an IPP reservoir should be tailored to the clinical scenario. In cases with peri-prosthetic infection and subsequent intravesical reservoir erosion, complete explantation and delayed subsequent reimplantation has been successful. Inadvertent intravesical reservoir placement has been successfully managed via immediate cystotomy, reservoir repositioning and cystorraphy. Reservoir insertion via a counter-incision, an infrapubic approach and under direct vision can avoid this complication. Bladder laceration during reservoir reinflation has been successfully managed with cystorraphy and reservoir repositioning.