Staller Angie L, Chang Courtney M, Wagenheim Gavin N, Wang Run
Division of Urology, University of Texas McGovern Medical School, Houston, Texas 77030, USA.
Department of Urology, University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA.
Asian J Androl. 2017 Jan-Feb;19(1):132-134. doi: 10.4103/1008-682X.188661.
In the setting of an infected inflatable penile prosthesis (IPP), removal of the reservoir is a surgical challenge. We describe a novel technique for IPP reservoir removal at the time of IPP explantation utilizing laparoscopic instruments. We present two cases of infected IPPs requiring complete removal of all components of the implant. The corporal cylinders and scrotal pump were removed via a single penoscrotal incision. Through the same incision, a lighted, hand-held retractor was used for visibility, and laparoscopic instruments were utilized to dissect the tissue surrounding reservoir and the attached tubing until free. Then, a completely intact reservoir was easily removed. Infected IPP reservoirs were successfully removed in this fashion without any complication. This new technique not only facilitated the safe removal of the reservoir, but also enhanced surgical efficiency by eliminating the need for additional incisions. We performed a review of current literature concerning techniques and indications for removal of IPPs and the reservoir. In the setting of an infected penile prosthesis, all components of the implant should be removed. Removal of the reservoir has been surgically difficult due to its location, either deep in the space of Retzius or high in the abdomen between the muscular fascias. Our new technique provides an innovative solution for reservoir removal with the use of laparoscopic instruments via a single penoscrotal incision. We have found that this technique overcomes the challenge of a cumbersome blind dissection and the need for the second incision.
在感染的可膨胀阴茎假体（IPP）的情况下，移除储液囊是一项外科挑战。我们描述了一种在IPP取出时利用腹腔镜器械移除IPP储液囊的新技术。我们展示了两例感染的IPP病例，需要完全移除植入物的所有组件。阴茎海绵体柱和阴囊泵通过单一的阴茎阴囊切口移除。通过同一个切口，使用带光源的手持牵开器以获得视野，并用腹腔镜器械解剖储液囊周围的组织及其附着的管道，直至其游离。然后，一个完整无损的储液囊就很容易被移除了。以这种方式成功移除了感染的IPP储液囊，没有出现任何并发症。这项新技术不仅有助于安全地移除储液囊，还通过无需额外切口提高了手术效率。我们对当前有关IPP及储液囊移除的技术和适应证的文献进行了综述。在感染的阴茎假体的情况下，应移除植入物的所有组件。由于储液囊位于Retzius间隙深处或腹部肌肉筋膜之间的高位，其移除在手术上一直很困难。我们的新技术通过单一的阴茎阴囊切口使用腹腔镜器械为储液囊移除提供了一种创新解决方案。我们发现这项技术克服了繁琐的盲目解剖的挑战以及需要第二个切口的问题。
