St. Joseph Medical Center, Houston, TX, USA.
Division of Urology, University of Texas Health Science Center-McGovern Medical School at Houston, Department of Surgery, Houston, TX, USA.
Sex Med Rev. 2019 Jul;7(3):521-529. doi: 10.1016/j.sxmr.2018.12.005. Epub 2019 Feb 18.
Inflatable penile prosthesis (IPP) surgery offers a high satisfaction rate and low rate of complications when performed by experienced surgeons. However, reservoir placement, either in the space of Retzius (SOR), or alternative/ectopic locations, may lead to an array of serious complications that may require revision surgery.
To review the prevalence and management options for non-infectious intraoperative and postoperative complications related to prosthetic reservoirs.
A Medline PubMed search was used to identify articles related to IPP reservoir-related complications including bladder and bowel injury, vascular injury, autoinflation, herniation, palpability, leakage, and tubing torsion.
Rates and types of reservoir-related complications during and after IPP surgery.
Non-infectious reservoir-related complications in the intraoperative setting include injury to pelvic structures such as bladder, bowel, and blood vessels. In the postoperative setting, patients may experience autoinflation and reservoir herniation that might require revision surgery. Patients undergoing alternative reservoir placement (ARP) may complain of reservoir palpability and premature mechanical failure secondary to reservoir leakage or tubing torsion.
Although most surgeons continue to use the SOR as the main location for reservoir placement, ARP has gained popularity owing to its low risk of bother, minimal loss of functionality, and safety advantages in patients with history of pelvic surgery. Both reservoir placement in the SOR and ARP carry a low rate of complications while maintaining a high satisfaction rate. Clavell-Hernández J, Shah A, Wang R. Non-Infectious Reservoir-Related Complications During and After Penile Prosthesis Placement. Sex Med Rev 2019;7:521-529.
经验丰富的外科医生进行可膨胀阴茎假体 (IPP) 手术时,其满意度高,并发症发生率低。然而,储液器的放置,无论是在 Retzius 间隙(SOR)内,还是在其他异位位置,都可能导致一系列严重的并发症,这些并发症可能需要进行修正手术。
回顾与假体储液器相关的非感染性术中及术后并发症的发生率和处理方法。
通过 Medline PubMed 检索,确定与 IPP 储液器相关并发症相关的文章,包括膀胱和肠损伤、血管损伤、自动充气、疝、触诊、渗漏和管扭结。
IPP 手术后和手术期间储液器相关并发症的发生率和类型。
非感染性储液器相关并发症在术中包括对骨盆结构如膀胱、肠和血管的损伤。在术后,患者可能会出现自动充气和储液器疝,这可能需要进行修正手术。接受替代储液器放置 (ARP) 的患者可能会出现储液器触诊和由于储液器渗漏或管扭结导致的早期机械故障。
尽管大多数外科医生仍然将 SOR 作为储液器放置的主要位置,但由于 ARP 并发症风险低、功能丧失最小,并且在有骨盆手术史的患者中具有安全性优势,因此其越来越受欢迎。SOR 和 ARP 中储液器的放置均具有较低的并发症发生率,同时保持较高的满意度。Clavell-Hernández J、Shah A、Wang R. 阴茎假体植入术后和术中的非感染性储液器相关并发症。性医学评论 2019;7:521-529.