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Abstract

Volume 19, Issue 1 (January 2017) 19, 132–134; DOI:10.4103/1008-682X.188661

A novel approach for removal of an inflatable penile prosthesis reservoir using laparoscopic instruments

Angie L Staller1, Courtney M Chang1, Gavin N Wagenheim1, Run Wang2

1 Division of Urology, University of Texas McGovern Medical School, Houston, Texas 77030, USA
2 Division of Urology, University of Texas McGovern Medical School, Houston, Texas 77030; Department of Urology, University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA

Correspondence: Prof. R Wang (run.wang@uth.tmc.edu)

Date of Submission 09-Jun-2016 Date of Decision 17-Jul-2016 Date of Acceptance 03-Aug-2016 Date of Web Publication 30-Sep-2016

Abstract

In the setting of an infected inflatable penile prosthesis (IPP), removal of the reservoir is a surgical challenge. We describe a novel technique for IPP reservoir removal at the time of IPP explantation utilizing laparoscopic instruments. We present two cases of infected IPPs requiring complete removal of all components of the implant. The corporal cylinders and scrotal pump were removed via a single penoscrotal incision. Through the same incision, a lighted, hand-held retractor was used for visibility, and laparoscopic instruments were utilized to dissect the tissue surrounding reservoir and the attached tubing until free. Then, a completely intact reservoir was easily removed. Infected IPP reservoirs were successfully removed in this fashion without any complication. This new technique not only facilitated the safe removal of the reservoir, but also enhanced surgical efficiency by eliminating the need for additional incisions. We performed a review of current literature concerning techniques and indications for removal of IPPs and the reservoir. In the setting of an infected penile prosthesis, all components of the implant should be removed. Removal of the reservoir has been surgically difficult due to its location, either deep in the space of Retzius or high in the abdomen between the muscular fascias. Our new technique provides an innovative solution for reservoir removal with the use of laparoscopic instruments via a single penoscrotal incision. We have found that this technique overcomes the challenge of a cumbersome blind dissection and the need for the second incision.

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