Avoiding deep pelvic complications using a 'Five-Step' technique for high submuscular placement of inflatable penile prosthesis reservoirs

被引：17

作者：

Baumgarten, Adam S. ^{[1
]}

Kavoussi, Mehraban ^{[1
]}

VanDyke, Maia E. ^{[1
]}

Ortiz, Nicolas M. ^{[1
]}

Khouri, Roger K., Jr. ^{[1
]}

Ward, Ellen E. ^{[1
]}

Hudak, Steven J. ^{[1
]}

Morey, Allen F. ^{[1
]}

机构：

[1] Univ Texas Southwestern Med Ctr Dallas, Dept Urol, 5323 Harry Hines Blvd, Dallas, TX 75390 USA

来源：

BJU INTERNATIONAL | 2020年 / 126卷 / 04期

关键词：

inflatable penile prosthesis; reservoir; erectile dysfunction; high submuscular; ectopic; ECTOPIC RESERVOIR; IMPLANTATION; OUTCOMES; EROSION; PROPPER; BLADDER; SPACE;

D O I：

10.1111/bju.15106

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Objectives To compare our extended experience with high submuscular (HSM) reservoir placement to traditional space of Retzius (SOR) placement and to present our current, refined 'Five-Step' technique (FST) for HSM placement. Patients and Methods Data were retrospectively collected on patients undergoing inflatable penile prosthesis (IPP) placement between January 2009 and June 2019. Re-operative cases were excluded. Reservoir-related complications and subsequent revisions were compared between SOR (2009-2012) and HSM reservoir groups (2012-2019). HSM patients were subdivided into two cohorts: 'Initial Technique' (2012-2014) and FST (2014-2019). The refined FST protocol was developed in 2014 to optimise outcomes and includes the following steps: (i) Position and Access; (ii) Develop Lower HSM Pocket; (iii) Develop Upper HSM Pocket; (iv) Reservoir Delivery (fill and fine-tune); (v) Confirm and Connect. Results Between January 2009 and June 2019, 733 total IPP procedures (586 HSM, 147 SOR) were performed by a single surgeon at our institution, 561 of which were virgin cases (430 HSM, 131 SOR) and included in this analysis. Overall, surgical revision was required in 10/430 (2.3%) HSM cases (one delayed bowel obstruction, nine herniations) and six of 131 (4.6%) SOR cases (one bladder erosion, two vascular injuries, and three herniations,P = 0.22). When comparing the FST to the Initial Technique, we noted a significant decrease in complications requiring surgical revision (P = 0.01). Among 133 cases performed with the Initial Technique, seven (5.3%) required surgical revision (one bowel obstruction after placement into the peritoneal cavity, six herniations). Among 297 FST cases, three (1.0%) required revision, all due to herniation. Conclusion HSM placement of IPP reservoirs is a safe alternative to traditional SOR placement. Major deep pelvic reservoir complications were minimised using our current refined FST.

引用

页码：457 / 463

页数：7

共 31 条

[1] Reservoir repositioning and successful thrombectomy for deep venous thrombosis secondary to compression of pelvic veins by an inflatable penile prosthesis reservoir [J].