MP62-07 ECTOPIC LOW SUBMUSCULAR RESERVOIR PLACEMENT WITH TRANSFASCIAL FIXATION FOR INFLATABLE PENILE PROSTHESIS

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP62-07 ECTOPIC LOW SUBMUSCULAR RESERVOIR PLACEMENT WITH TRANSFASCIAL FIXATION FOR INFLATABLE PENILE PROSTHESIS Nikola Rakic, Amelia Khoei, Utsav Bansal, and Mohit Khera Nikola RakicNikola Rakic More articles by this author , Amelia KhoeiAmelia Khoei More articles by this author , Utsav BansalUtsav Bansal More articles by this author , and Mohit KheraMohit Khera More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003320.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The objective of this study is to build upon work demonstrating novel low submuscular (LSM) reservoir placement with transfacial fixation (TFF) for inflatable penile prostheses (IPP). Several techniques have been described for placement of IPP reservoirs, with variable results. Our aim is to further demonstrate a novel approach to reservoir concealment with patient reported satisfaction outcomes as a suitable alternative. METHODS: A retrospective review was conducted on patients who underwent an IPP placement using the LSM with TFF technique between 6/2019 and 7/2022 by a single surgeon at a tertiary medical center. Preoperative patient characteristics were collected, and we conducted a telephone interview with a questionnaire to assess satisfaction with the IPP and reservoir concealment. Technique Once the IPP has been placed via a transverse scrotal incision, the external inguinal ring is identified. An S-retractor is placed in the external ring and the fascia is elevated. Ring forceps are used to develop a space inside the ring below the rectus muscle and above the transversalis fascia. An Allis clamp is employed to grasp the lateral aspect of the inguinal ring and a right angle is passed in an out-to-in fashion through the fascia. The reservoir tubing is grasped and brought through the fascia and the reservoir is then placed underneath the rectus muscle. RESULTS: A total of 36 patients underwent low submuscular reservoir placement with TFF of which 28 completed the questionnaire (77.7%). The average age of patients was 69.3 years, and 57.1% of patients had undergone a radical prostatectomy. Overall satisfaction with the penile implant was 4.1 (out of 5). Eight patients (28.6%) were able to palpate the reservoir, and four patients (14.3%) were able to visualize the reservoir below the abdominal skin. However, overall satisfaction with reservoir concealment was 4.5 (out of 5) (Table 1). No surgical revisions were required and there were no complications such as bowel obstruction, herniations, bladder erosion, or vascular injuries. CONCLUSIONS: The low submuscular placement with TFF of the IPP reservoir remains an optimal approach for reservoir placement with a high degree of patient satisfaction and significant ease of placement compared to alternative methods. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e864 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Nikola Rakic More articles by this author Amelia Khoei More articles by this author Utsav Bansal More articles by this author Mohit Khera More articles by this author Expand All Advertisement PDF downloadLoading ...