University of Texas Health Science Center, McGovern Medical School at Houston, Texas.
University of Texas MD Anderson Cancer Center, Houston, Texas.
J Urol. 2019 Mar;201(3):581-586. doi: 10.1016/j.juro.2018.10.013.
Alternative or ectopic reservoir placement has recently gained popularity among prosthetic surgeons to avoid injury to pelvic structures during inflatable penile prosthesis implantation. However, the true incidence of complications associated with these new techniques remains under studied. We performed a 5-year multicenter, retrospective study with the aim of evaluating complications related to alternative reservoir placement.
We retrospectively reviewed the database of inflatable penile prosthesis surgery at 3 institutions from February 2011 to December 2016. The mechanism of failure and complications related to reservoir placement were analyzed.
A total of 974 inflatable penile prostheses were placed in the 5-year period by 3 surgeons, including 612 surgeries with alternative reservoir placement. Mean followup to the emergence of reservoir related complications was 20.4 months. There was no significant difference in complication rates between primary and revision cases (p = 0.72). A total of 12 cases (2.0%) required revision for reservoir related complications in the alternative reservoir placement group vs 1.3% in the space of Retzius group (p = 0.44). The most common complication in the alternative reservoir placement group was reservoir leakage, which developed in 5 patients. Three cases required revision due to abdominal muscular pain. Torsion in the tubing of 3 Conceal™ reservoirs was found which caused blockage of fluid transportation. One reservoir was incidentally found to be intraperitoneal on unrelated imaging.
Alternative reservoir placement is a safe and mechanically reliable approach, including in men with prior pelvic surgery. However, there are associated risks, including reservoir leakage, tubing torsion, muscle discomfort and unintended reservoir malposition which may require surgical revision.
在进行可膨胀阴茎假体植入术时，为避免损伤骨盆结构，假体外科医生最近开始倾向于选择替代或异位储液器放置。然而，这些新技术相关并发症的真实发生率仍研究不足。我们进行了一项为期 5 年的多中心回顾性研究，旨在评估与替代储液器放置相关的并发症。
我们回顾性分析了 2011 年 2 月至 2016 年 12 月 3 家机构的可膨胀阴茎假体手术数据库。分析了储液器放置的失败机制和相关并发症。
在 5 年期间，3 位外科医生共完成了 974 例可膨胀阴茎假体手术，其中 612 例采用了替代储液器放置。出现与储液器相关并发症的平均随访时间为 20.4 个月。原发性和翻修病例的并发症发生率无显著差异（p = 0.72）。在替代储液器放置组中，共有 12 例（2.0%）因储液器相关并发症需要翻修，而在耻骨后间隙组中，这一比例为 1.3%（p = 0.44）。在替代储液器放置组中，最常见的并发症是储液器渗漏，有 5 例患者发生。由于腹部肌肉疼痛，有 3 例需要翻修。3 例 Conceal™储液器的管内扭结导致了液体输送阻塞。在无关影像学检查中，意外发现 1 例储液器位于腹腔内。
替代储液器放置是一种安全且机械可靠的方法，包括在有既往骨盆手术史的男性中。然而，这种方法也存在相关风险，包括储液器渗漏、管内扭结、肌肉不适和储液器位置不当，可能需要手术翻修。
