Amini Armon D, Nealon Samantha W, Badkhshan Shervin, Langford Brian T, Matz Ethan L, VanDyke Maia E, Franzen Bryce P, Morey Allen F
Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX 75390-9110, United States.
J Sex Med. 2025 Jan 3;22(1):170-174. doi: 10.1093/jsxmed/qdae155.
Three common strategies exist for managing the inflatable penile prosthesis reservoir during revision surgery: the original reservoir can be (a) removed, (b) deactivated and left in situ, sometimes referred to as "drain and retain" (DR), or (c) validated and reconnected to new cylinders, which we have termed "reservoir recycling" (RR).
To compare the efficacy and safety of the RR approach to penile prosthesis revision against DR and the recommended approach of complete device removal and replacement.
A retrospective chart review of our single-surgeon inflatable penile prosthesis database between 2007 and 2022 was performed, identifying revision surgeries. Cases were stratified by reservoir management technique. Patients who had undergone at least 1 follow-up visit and had complete documentation regarding reservoir handling were included. Reservoir-related complications necessitating surgical intervention such as infection and device failure were compared between the 3 groups using a chi-square test. Mean follow-up duration, time to revision, and operative time were also assessed.
The primary outcome was the incidence of reservoir-related complications requiring surgical intervention and secondary outcomes included time to revision surgery and operative time.
Among 140 patients meeting inclusion criteria, 62 underwent full reservoir replacement (FR), 48 DR, and 30 RR. Compared to FR, DR and RR groups had similar mean time to revision and intraoperative time. Follow-up duration was similarly limited for all 3 groups at a median of approximately 4.5 months. There were no postoperative infections in the RR cohort. However, when compared to the DR and FR groups, this did not reach significance (P = .398). There was no difference in mechanical failure rate between the 3 groups (P = .059). Nonmechanical failure was also similar between all 3 groups (P = .165).
These results suggest that RR exhibits comparable outcomes to DR and FR, making it a viable option during select penile prosthesis revision surgeries, potentially decreasing morbidity without compromising outcomes.
This is the first study to evaluate outcomes after RR. Limitations include small sample size, limited follow-up, and single-surgeon experience.
There was no difference in reservoir-related complications when comparing the 3 methods. These preliminary results suggest that reservoir recycling may provide a safe and effective reservoir-handling alternative in inflatable penile prosthesis revision surgery.
在翻修手术中，对于可膨胀阴茎假体储液囊的处理存在三种常见策略：原储液囊可以（a）移除，（b）停用并留在原位，有时称为“引流并保留”（DR），或者（c）验证后重新连接到新的圆柱体，我们称之为“储液囊再利用”（RR）。
比较RR方法与DR以及推荐的完全移除并更换装置的方法在阴茎假体翻修中的疗效和安全性。
对我们单中心2007年至2022年间的可膨胀阴茎假体数据库进行回顾性图表审查，以识别翻修手术。病例按储液囊处理技术分层。纳入至少接受过1次随访且有关于储液囊处理完整记录的患者。使用卡方检验比较三组中需要手术干预的与储液囊相关的并发症，如感染和装置故障。还评估了平均随访时间、翻修时间和手术时间。
在140例符合纳入标准的患者中，62例行储液囊完全更换（FR），48例行DR，30例行RR。与FR相比，DR组和RR组的平均翻修时间和术中时间相似。所有三组的随访时间同样有限，中位数约为4.5个月。RR队列中无术后感染。然而，与DR组和FR组相比，差异无统计学意义（P = 0.398）。三组之间的机械故障率无差异（P = 0.059）。所有三组之间的非机械故障率也相似（P = 0.165）。
这些结果表明，RR与DR和FR的结果相当，使其成为特定阴茎假体翻修手术中的一个可行选择，可能在不影响疗效的情况下降低发病率。
这是第一项评估RR术后结果的研究。局限性包括样本量小、随访有限以及单中心经验。
比较这三种方法时，与储液囊相关的并发症无差异。这些初步结果表明，储液囊再利用可能为可膨胀阴茎假体翻修手术提供一种安全有效的储液囊处理替代方法。
