Articles

No Touch Modified Ectopic Reservoir Placement

Author: Mohammed Hamdan, MD

Key Words: Ectopic, reservoir, inflatable penile prosthesis

IPP reservoir has been traditionally placed at the retropubic space of Retzius. Multiple severe complications have been reported with retropubic placement, including vascular, bladder and bowel injuries due to blind insertion of the reservoir through a puncture of the inguinal canal floor.  In this video, we demonstrate our technique for ectopic deep subcutaneous reservoir placement through penoscrotal incision under vision.  This technique was implemented by a single high-volume surgeon in 52 patients with a median follow up of 1 year.  One patient developed infection, which was treated by Mulcahy salvage removal of implant components and insertion of malleable implant. No patients experienced reservoir prolapse, reservoir herniation, or implant malfunction. Visible or palpable reservoirs were only noticed in thin patients and became significantly less visible two months after surgery.

Deep subcutaneous insertion may be a safe, easy alternative location for reservoir placement in average and overweight patients, or in those with previous pelvic or abdominal surgery.

Acknowledgement: None

Disclosures: The author has nothing to disclose.

References:

  1. Wilson SK, Henry GD, Delk JR, Cleves MA. Mentor Alpha 1 penile prosthesis with reservoir lock-out valve: effective prevention of auto-inflation with improved capability for ectopic reservoir placement. J Urol 2002; 168: 1475.
  2. Morey A, Wilson SK. Submuscular reservoir placement. J Sex Med 2013; 10: 1672.
  3. Levine L, Hoeh M. Review of penile prosthetic reservoir: complications and presentation of a modified reservoir placement technique. J Sex Med. 2012;9:2759-2769.
  4. Perito P, Wilson S. Traditional (retroperitoneal) and abdominal wall (ectopic) reservoir placement. J Sex Med. 2011;8:656-659.