MP57-18 FEASIBILITY AND SAFETY OF STANDARD RETROPUBIC PENILE PROSTHESIS RESERVOIR PLACEMENT FOR HIGH-RISK PATIENTS

Abstract

You have accessJournal of UrologySexual Function/Dysfunction: Surgical Therapy (MP57)1 Sep 2021MP57-18 FEASIBILITY AND SAFETY OF STANDARD RETROPUBIC PENILE PROSTHESIS RESERVOIR PLACEMENT FOR HIGH-RISK PATIENTS Elizabeth Boes, Parth Thakker, Rahul Dutta, Adam Cohen, Kyle Scarberry, and Ryan Terlecki Elizabeth BoesElizabeth Boes More articles by this author , Parth ThakkerParth Thakker More articles by this author , Rahul DuttaRahul Dutta More articles by this author , Adam CohenAdam Cohen More articles by this author , Kyle ScarberryKyle Scarberry More articles by this author , and Ryan TerleckiRyan Terlecki More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002087.18AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Traditional reservoir placement for the 3-piece inflatable penile prosthesis (IPP) has involved the space of Retzius (SOR). Developing this space may be daunting for infrequent implanters, especially in the setting of prior inguinal or pelvic surgery. As such, some have advocated for ectopic reservoir placement, with potential risks for visibility, palpability, and possibly less predictable complications. We chose to review our experience to determine the feasibility and safety of SOR reservoir placement. METHODS: Our IRB-approved single-surgeon database was reviewed for all cases of three-piece penile implant placement from 2011-2020. Demographics, patient history, operative details, and outcomes were reviewed. Cases involving a history of robotic prostatectomy (RP), mesh-based inguinal hernia repair (MIHR), renal transplant (TX), cystectomy (CX), or pelvic fracture (PF) were deemed high-risk for SOR reservoir placement. RESULTS: 554 men underwent 3-piece IPP placement during the studied interval, all via a penoscrotal approach. Age at time of implant ranged from 38 - 86 years and mean BMI was 29.94 (17.7-52.4) kg/m2. Mean follow-up was 1623 (370-3710) days. 209 men (37.7%) were deemed high risk for SOR reservoir placement based on prior RP (166; 28.7%) MIHR (43; 7.43%), TX (15; 2.59%) CX (2; 0.345%), or PF (11; 1.9%). SOR placement required a counter-incision in 5 men (0.9%), and ectopic placement was required in 10 (1.8%). Ectopic placement was significantly associated with prior PF (p=0.014), but not with RP, MIRH, TX, or CX. High-risk patients were more likely to require a counter-incision to access the SOR (1.91 vs 0.29%, respectively; p=0.049). No bowel or bladder complications were encountered. One case involving SOR placement required repositioning due to iliac vein compression. CONCLUSIONS: Even in high-risk patients, penoscrotal SOR reservoir placement is feasible and safe, without the need for a counter-incision in 99% of patients. Ectopic placement was statistically more common in men with prior PF. A high-volume multicenter comparison seems warranted to determine if one approach is superior or if ectopic placement should be reserved for more well-defined populations. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e986-e986 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Elizabeth Boes More articles by this author Parth Thakker More articles by this author Rahul Dutta More articles by this author Adam Cohen More articles by this author Kyle Scarberry More articles by this author Ryan Terlecki More articles by this author Expand All Advertisement Loading ...