Açık radikal retropubik prostatektomi sonrası inflatable penil protez rezervuarı, penoskrotal transvers insizyon ile Retzius alanına güvenle yerleştirilebilir

Abstract

OBJECTIVE:The traditional placement area of three-pieces inflatable penile prosthesis (3pIPP) reservoir is the space of Retzius (SOR) below the transversalis fascia. Likelihood of developing of fibrosis after previous pelvic surgery may be a challenging factor that can make difficult to place reservoir in the SOR. We reviewed our experience to address potential complications and safety concerns regarding the placement of the penile prosthesis reservoir in the SOR using transverse scrotal incision. MATERIAL and METHODS:Of the 122 consecutive patients underwent 3pIPP placement from 2010 to 2017, 39 had a history of open radical retropubic prostatectomy (ORRP) for localized prostate cancer (PCa) (ORRP group). Of these patients, 7 were placed MS-LGX, 18 were placed AMS-700 CX, and 14 were placed Coloplast Titan device using penoscrotal incision. Eighty-three patients had no history of ORRP (Non-ORRP group). Six patients were placed MS-LGX, 19 were placed AMS-700 CX, and 58 were placed Coloplast Titan device using penoscrotal incision. The groups were compared in terms of demographic characteristics, intraoperative findings, and postoperative follow-up data. RESULTS:The mean ages of the ORRP and Non-ORRP groups were 62.2±6.5 and 58.6±9.5 (p=0.06); the mean surgery times were 57.2±11.3 and 56.7±5.3 min (p=0.32); the mean follow-up periods were 58.7±36.9 and 50.1±27.5 months (p=0.33), respectively. Mechanical failure in one patient (2.6%) and prosthesis infection in one patient (2.6%) was observed in the ORRP group. In the Non-ORRP group, reservoir dislocation due to inguinal hernia in a patient (2.6%), mechanical failure in three patients (3.6%), and prosthesis infection in a patient (1.2%) was observed. The mean postoperative treatment satisfaction rates (EDITS) were 86.8±11.3 and 85.8±12.2 in ORRP and Non-ORRP groups, respectively (p=0.91). CONCLUSION:With low complication rates, 3pIPP with its reservoir can safely be placed in patients with a history of open radical prostatectomy using penoscrotal incision. Rarely, ectopic reservoir placement is required, and this apparatus should be available at the time of surgery.