Reservoir in Reservoir: Complete Erosion of the Inflatable Penile Prosthesis Reservoir into the Urinary Bladder

Q. Walcott, D. Nusbaum, S. Faris, O. Raheem, E. Kocjancic

Reservoir erosion of an inflatable penile prosthesis into the urinary bladder is an exceedingly rare but serious complication. We present a surgical video demonstrating the evaluation and management of a patient with complete intravesical erosion of the prosthesis reservoir.

The patient presented with lower urinary tract symptoms and recurrent urinary tract infections following prior inflatable penile prosthesis placement. Diagnostic evaluation including cystoscopy confirmed complete migration and erosion of the reservoir into the bladder lumen. The surgical video illustrates the operative steps for safe removal of the eroded reservoir and management of the associated bladder defect.

Under cystoscopic and open surgical guidance, the intravesical reservoir was identified and carefully extracted. The bladder defect was repaired in a multilayer fashion and urinary drainage was maintained postoperatively to facilitate healing. The remaining prosthesis components were evaluated and managed according to intraoperative findings.

This video highlights a rare complication of penile prosthesis surgery and demonstrates key technical considerations for diagnosis and management. Awareness of this complication and adherence to careful surgical technique are essential to minimize morbidity and ensure safe prosthesis management.

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