Midline Reservoir Placement of Infrapububic Inflatable Penile Prosthesis

Kalidoss, S, Suarez-Sarmiento, A, Raheem, O, Perito, P

Inflatable penile prosthesis, revision procedure, alternative reservoir placement, midline reservoir, erectile dysfunction

This video details the midline surgical placement of an inflatable penile prosthesis (IPP) implant reservoir, which is a safe and effective alternative location for patients with prior pelvic surgery, injuries, or atypical pelvic anatomy. The reservoir can be implanted anterior or posterior to the transversalis fascia superior to the bladder, providing an easily accessible location that is familiar to all urologists. This differs from the traditional retroperitoneal reservoir placement in the Space of Retzius. Pelvic trauma, history of surgery in the pelvic region, and atypical anatomy can necessitate an alternative location for implantation of the IPP reservoir. Patients with compromised pelvic, abdominal, or inguinal regions due to hernia repair, patulous inguinal rings, or dense lateral pelvic scarring stand to benefit the most from this midline reservoir placement. The midline placement of the IPP reservoir provides numerous advantages in outcomes, patient experience, and versatility of implantation.

References:

1.    Karpman E, Sadeghi-Nejad H, Henry G, Khera M, Morey AF. Current opinions on alternative reservoir placement for inflatable penile prosthesis among members of the Sexual Medicine Society of North America. J Sex Med. 2013 Aug;10(8):2115-20. eng. Epub 20130516. doi:10.1111/jsm.12203.

2.    Madiraju SK, Hakky TS, Perito PE, Wallen JJ. Placement of Inflatable Penile Implants in Patients With Prior Radical Pelvic Surgery: A Literature Review. Sex Med Rev. 2019 Jan;7(1):189-197. eng. Epub 20181130. doi:10.1016/j.sxmr.2018.10.002.

3.    Gross MS, Stember DS, Garber BB, Perito PE. A retrospective analysis of risk factors for IPP reservoir entry into the peritoneum after abdominal wall placement. Int J Impot Res. 2017 Sep;29(5):215-218. doi: 10.1038/ijir.2017.26

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