PD28-04 RESERVOIR DISTANCE FROM CRITICAL PELVIC STRUCTURES: RADIOGRAPHIC COMPARISON OF HIGH SUBMUSCULAR AND SPACE OF RETZIUS INFLATABLE PENILE PROSTHESIS PLACEMENT TECHNIQUES

Abstract

You have accessJournal of UrologyCME1 May 2022PD28-04 RESERVOIR DISTANCE FROM CRITICAL PELVIC STRUCTURES: RADIOGRAPHIC COMPARISON OF HIGH SUBMUSCULAR AND SPACE OF RETZIUS INFLATABLE PENILE PROSTHESIS PLACEMENT TECHNIQUES Mehraban Kavoussi, Grayden Cook, Shaun Nordeck, Shervin Badkhshan, Samantha Nealon, Benjamin Dropkin, Gregory Joice, Sarah Sanders, Jeffrey Pruitt, Steven Hudak, and Allen Morey Mehraban KavoussiMehraban Kavoussi More articles by this author , Grayden CookGrayden Cook More articles by this author , Shaun NordeckShaun Nordeck More articles by this author , Shervin BadkhshanShervin Badkhshan More articles by this author , Samantha NealonSamantha Nealon More articles by this author , Benjamin DropkinBenjamin Dropkin More articles by this author , Gregory JoiceGregory Joice More articles by this author , Sarah SandersSarah Sanders More articles by this author , Jeffrey PruittJeffrey Pruitt More articles by this author , Steven HudakSteven Hudak More articles by this author , and Allen MoreyAllen Morey More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002576.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Inflatable penile prosthesis (IPP) reservoir placement into the High Submuscular space (HSM) has been proposed as a strategy to prevent injury to organs adjacent to the Space of Retzius (SOR). SOR reservoir proximity to critical pelvic structures (CPS) has been previously established in a cadaver study. We sought to evaluate reservoir distance from CPS for SOR and HSM placements using cross-sectional imaging obtained following IPP insertion. METHODS: We retrospectively reviewed our institutional database and identified men who underwent IPP insertion between 2007 and 2020. Men who underwent subsequent cross-sectional abdominopelvic imaging following IPP insertion until October 2020 were included in this study. Two radiologists blinded to IPP surgical technique evaluated reservoir position to determine (a) mass effect on the bladder and iliac vessels and (b) the shortest distance between each of these structures and the reservoir. Men were grouped based on reservoir placement technique (SOR vs. HSM) as documented in the operative notes. Variables were analyzed using chi-squared, fisher’s exact, and student’s T-tests as indicated. RESULTS: Among 1010 IPP cases performed during the study interval, 139 (13.7%) met our inclusion criteria with imaging obtained an average of 827 ( + 785) days after IPP insertion. Oncologic follow-up (46%) was the most common indication for imaging. Compared with SOR reservoirs (n = 32), HSM reservoirs (n =107) were significantly less likely to induce a mass effect on the bladder (72 vs. 9%) or iliac vessels (34 vs. 4%) and were located roughly 5x further from the bladder (10 + 22 vs. 49 + 36 mm) and iliac vessels (5 + 9 vs. 23 + 26 mm, Table). CONCLUSIONS: This study radiographically confirms that IPP reservoirs are located significantly further away from CPS following HSM placement compared to SOR placement. These findings suggest a potential patient safety benefit via avoidance of bladder and iliac vessel related IPP reservoir complications. Source of Funding: N/A © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e500 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mehraban Kavoussi More articles by this author Grayden Cook More articles by this author Shaun Nordeck More articles by this author Shervin Badkhshan More articles by this author Samantha Nealon More articles by this author Benjamin Dropkin More articles by this author Gregory Joice More articles by this author Sarah Sanders More articles by this author Jeffrey Pruitt More articles by this author Steven Hudak More articles by this author Allen Morey More articles by this author Expand All Advertisement PDF DownloadLoading ...