Pd42-07 outcomes related to inflatable penile prosthesis (ipp) reservoir removal: a 7-year multi-center experience

You have accessJournal of UrologyCME1 Apr 2023PD42-07 OUTCOMES RELATED TO INFLATABLE PENILE PROSTHESIS (IPP) RESERVOIR REMOVAL: A 7-YEAR MULTI-CENTER EXPERIENCE Javier Piraino, Ian Madison, Matthew Ziegelmann, Run Wang, Tobias Kohler, Aram Loeb, Gerard Henry, Robert Cornell, Dylan Supak, Landon Trost, and Jonathan Clavell Javier PirainoJavier Piraino More articles by this author , Ian MadisonIan Madison More articles by this author , Matthew ZiegelmannMatthew Ziegelmann More articles by this author , Run WangRun Wang More articles by this author , Tobias KohlerTobias Kohler More articles by this author , Aram LoebAram Loeb More articles by this author , Gerard HenryGerard Henry More articles by this author , Robert CornellRobert Cornell More articles by this author , Dylan SupakDylan Supak More articles by this author , Landon TrostLandon Trost More articles by this author , and Jonathan ClavellJonathan Clavell More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003352.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The 3-piece IPP is the most widely used device for erectile dysfunction refractory to medications, containing a reservoir inserted into the Space of Retzius (SOR) or an alternative/ectopic space (AES). Indications for removal of the reservoir include malfunction, malposition or infection. In revision cases without infection, reservoir removal is sometimes optional. We review outcomes and complications specifically related to reservoir removal from a large multi-institutional series. METHODS: We retrospectively reviewed databases at 6 institutions over 7 years. Patients with artificial urethral sphincter, urethral sling or Mini-jupette were excluded. Outcomes and complications related to IPP reservoir removal were analyzed. Data were collected but only reservoir-related complications at surgery were included. Data were compared between SOR and AES cohorts to evaluate differences with χ2, with significance at p<0.05. RESULTS: Of 215 cases, there were 172 SOR (80%) and 43 AES (20%) reservoirs. Mean patient age was 65.3 years old. 131 (60.9%) procedures were due to malfunction, 49 (22.8%) were due to malposition of an IPP component, and 35 (16.3%) were secondary to infection. Among those retained (N=44, 20.5%), reasons included reuse, avoiding surrounding structure damage, unspecified, and difficult dissection. Among those removed (N=171), 15 (8.8%) required a counter-incision (6 in SOR and 9 in AES). χ2 to determine statistical difference between those removed from SOR and AES found a p=0.00059, indicating significant difference in the need for a counter-incision those groups. Complications included bladder perforation (N=1) in the SOR group, and an avulsion of the epigastric vessels requiring abdominal exploration (N=1) in the AES group. χ2 to determine statistical difference when comparing SOR and AES complications was p=0.365, indicating no significant difference between groups. CONCLUSIONS: Removal of an IPP reservoir remains safe with few complications. Surgeons should be aware of the inferior epigastric vessels during removal in an AES or be willing to perform a counter incision to avoid injury to surrounding structures. Surgeons should obtain preoperative imaging to identify the specific location of the reservoir and adjacent anatomy. This is the first and largest multi-institutional study reviewing outcomes related to reservoir removal during IPP revision or removal surgery. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1113 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Javier Piraino More articles by this author Ian Madison More articles by this author Matthew Ziegelmann More articles by this author Run Wang More articles by this author Tobias Kohler More articles by this author Aram Loeb More articles by this author Gerard Henry More articles by this author Robert Cornell More articles by this author Dylan Supak More articles by this author Landon Trost More articles by this author Jonathan Clavell More articles by this author Expand All Advertisement PDF downloadLoading ...