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R. Garcia-Baquero, M.J. Calvo Lopez, C. Lafuente Molinero, J. Cañete Bermudez, P. Parra Servan, A.V. Ojeda Claro, C.M. Fernandez Avila, A. Flor Peña, C. Leon Delgado, B. Madurga Patuel, J.L. Alvarez-Ossorio Fernandez, PS-05-014 Anatomic Location of Inflatable Penile Prosthesis Reservoir in Transperitoneal Laparoscopic Radical Prostatectomy Patients, The Journal of Sexual Medicine, Volume 14, Issue Supplement_4a, April 2017, Pages e122–e123, https://doi.org/10.1016/j.jsxm.2017.03.116
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Objective
Some surgeon’s think that three-piece inflatable prosthesis (IPP) shouldn’t be offered to patients who have undergone retropubic surgery because of a possible increase in intraoperative risk during reservoir placement into the retropubic space. Our objetives are to demostrate that reservoir placement in patients whom were performed trasperitoneal laparoscopic radical prostactectomy without Retzius space reconstruction (TLRPwr) is a safe procedure and to know if there is any difference in its anatomic location in comparison to patients without previos abdominal surgery.
Methods
Of 47 consecutive patients undergoing IPP placement from 2012 to 2016 in our hospital, 10 had undergone TLPRwr before placement of a Titan OTR device (Coloplast®). We compared this group of patients with a matched group of 10 patients with vasculogenic erectile dysfunction without previous abdominal surgery. Intraoperative and follow up data, and reservoir anatomic localization estimated by magnetic resonance imaging (MRI) were compared between groups.
Results
All IPP placements were completed as planned without intraoperative complications. An increase amount of scarring made the fascia more difficult to perforate, but blind entrance to retropubic space was performed successfully in all TLRPwr patients. There was no differences between groups in intraoperative and follow up data (p>0.05). Measuring the distance from the reservoir to the external inguinal ring and to the pubic symphysis by MRI, we saw that the reservoir usually is nearer to the external inguinal ring and in a retropubic location rather than deeper and lateral to the bladder, as it was seen in patients without previous abdominal surgery (p<0.05).
