Penile Prosthesis Reservoir Removal: Surgical Description and Patient Outcomes

Jonathan Clavell-Hernández, Samuel G. Aly, Run Wang, Hossein Sadeghi-Nejad

Research output: Contribution to journalArticle

Abstract

Background: Removal of the penile prosthesis reservoir can be technically challenging because of its difficult locations either deep in the pelvis or high in the abdominal wall. Aim: To describe a detailed surgical technique for reservoir removal through a penoscrotal approach. Methods: We describe our preferred method for removal of prosthetic reservoir and present a retrospective review of patient outcomes after reservoir removal. Main Outcome Measure: Primary outcomes included immediate or late complications. Secondary outcomes included operative time. Results: 34 patients underwent reservoir removal with the use of our described technique. 23 patients (67.6%) had reservoirs removed because of device malfunction and 11 (32.4%) because of infection. A total of 18 reservoirs (52.9%) were found in the space of Retzius (SOR), whereas the other 16 (47.1%) were in an alternative/ectopic space. 2 cases (5.9%) required a counterincision to remove the reservoir. Mean overall operative time was 96.2 minutes (range 35–175). There were no complications in this series. There was no statistical difference in operative time between reservoirs removed because of malfunction when compared with infection (P =.283). However, there was a difference in operative time between reservoirs removed from the SOR when compared with those removed from an ectopic space, with mean operating room times of 104.5 and 75.4 minutes, respectively (P =.001). Clinical Implications: Reservoir removal through a penoscrotal incision is feasible and safe. Strength & Limitations: This is the first report, to our knowledge, describing surgical techniques and outcomes for reservoir removal. Limitations include its retrospective nature and lack of validated questionnaires to assess patient satisfaction. Conclusion: Although removal of a reservoir deep in the SOR or placed in alternate/ectopic locations can be challenging, the use of a lighted retractor, meticulous dissection, and a few technical maneuvers described allow for safe removal of the reservoir completely intact while avoiding complications. Our technique for a secondary incision in particularly difficult cases is also described. Clavell-Hernández J, Aly SG, Wang R, et al. Penile Prosthesis Reservoir Removal: Surgical Description and Patient Outcomes. J Sex Med 2019;16:146–152.

Original languageEnglish
Pages (from-to)146-152
Number of pages7
JournalJournal of Sexual Medicine
Volume16
Issue number1
DOIs
StatePublished - Jan 1 2019

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Penile Prosthesis
Operative Time
Abdominal Wall
Operating Rooms
Infection
Pelvis
Patient Satisfaction
Dissection
Outcome Assessment (Health Care)
Equipment and Supplies

Keywords

  • Alternate Reservoir Placement
  • Erectile Dysfunction
  • Penile Prosthesis
  • Reservoir Removal
  • Space of Retzius

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology
  • Urology

Cite this

Penile Prosthesis Reservoir Removal : Surgical Description and Patient Outcomes. / Clavell-Hernández, Jonathan; Aly, Samuel G.; Wang, Run; Sadeghi-Nejad, Hossein.

In: Journal of Sexual Medicine, Vol. 16, No. 1, 01.01.2019, p. 146-152.

Research output: Contribution to journalArticle

Clavell-Hernández, J, Aly, SG, Wang, R & Sadeghi-Nejad, H 2019, 'Penile Prosthesis Reservoir Removal: Surgical Description and Patient Outcomes' Journal of Sexual Medicine, vol. 16, no. 1, pp. 146-152. https://doi.org/10.1016/j.jsxm.2018.11.002
Clavell-Hernández, Jonathan ; Aly, Samuel G. ; Wang, Run ; Sadeghi-Nejad, Hossein. / Penile Prosthesis Reservoir Removal : Surgical Description and Patient Outcomes. In: Journal of Sexual Medicine. 2019 ; Vol. 16, No. 1. pp. 146-152.
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