Karpman Edward, Sadeghi-Nejad Hossein, Henry Gerard, Khera Mohit, Morey Allen F
Men’s Health, Male Reproductive and Sexual Medicine, Microsurgery, El Camino Urology Medical Group, Inc., A Division of Urological Surgeons of Northern California (USNC), 2490 Hospital Drive,Suite 210, Mountain View, CA 94040, USA.
J Sex Med. 2013 Aug;10(8):2115-20. doi: 10.1111/jsm.12203. Epub 2013 May 16.
The Sexual Medicine Society of North America (SMSNA) includes as its members the most experienced prosthetic surgeons in North America who implant inflatable penile prostheses (IPPs). Obliteration of the space of Retzius (SOR) resulting from robotic-assisted laparoscopic prostatectomy (RALP) is a growing concern that has prompted many surgeons to look for alternative locations for reservoir placement during IPP implantation.
The aim of this article is to educate the community of prosthetic urologists about potential complications and alternative locations for IPP reservoir placement.
A panel of high-volume experienced prosthetic surgeons discussed their views on alternative IPP reservoir implantation during a symposium focused on this topic. After reviewing reservoir complications, physician members of the SMSNA in attendance were surveyed using an audience response system (ARS) to facilitate sharing of knowledge, opinions, and recommendations related to reservoir implantation.
Six ARS questions were used to identify the percentages of SMSNA member physicians with concerns about traditional IPP reservoir placement and utilizing alternative reservoir placement (ARP), and the impact of changing practice patterns on patient safety.
A majority (81%) of experienced implant surgeons surveyed think that RALP sometimes or frequently makes traditional IPP reservoir placement more difficult. Placement of the reservoir in an alternative location is sometimes or frequently advantageous for patient safety. A vast majority (97%) of the 95 respondents indicated that ARP techniques should be included in physician training courses.
Physicians have concerns about reservoir placement in the SOR in RALP patients, which may explain why ARP is popular among SMSNA members. Device manufacturers should support physician training that provides for ARP. Clinical outcomes in RALP patients are needed to better understand the risks and benefits, and define the ideal location of reservoir placement in this population.
北美性医学协会（SMSNA）的成员包括北美最有经验的植入可膨胀阴茎假体（IPP）的修复外科医生。机器人辅助腹腔镜前列腺切除术（RALP）导致的耻骨后间隙（SOR）闭塞是一个日益受到关注的问题，这促使许多外科医生在IPP植入期间寻找储液器放置的替代位置。
本文的目的是向修复泌尿外科医生群体介绍IPP储液器放置的潜在并发症和替代位置。
一组经验丰富的高产量修复外科医生在一次专注于该主题的研讨会上讨论了他们对IPP储液器替代植入的看法。在回顾储液器并发症后，使用观众反应系统（ARS）对出席的SMSNA医生成员进行了调查，以促进与储液器植入相关的知识、意见和建议的分享。
使用六个ARS问题来确定对传统IPP储液器放置表示担忧并采用替代储液器放置（ARP）的SMSNA成员医生的百分比，以及改变实践模式对患者安全的影响。
接受调查的大多数（81%）经验丰富的植入外科医生认为RALP有时或经常会使传统IPP储液器放置更加困难。将储液器放置在替代位置有时或经常对患者安全有利。95名受访者中的绝大多数（97%）表示，ARP技术应纳入医生培训课程。
医生对RALP患者耻骨后间隙中的储液器放置存在担忧，这可能解释了为什么ARP在SMSNA成员中很受欢迎。设备制造商应支持提供ARP的医生培训。需要RALP患者的临床结果，以更好地了解风险和益处，并确定该人群中储液器放置的理想位置。
