scholarly journals Preperitoneal placement of an inflatable penile prosthesis reservoir for postoperative erectile dysfunction after radical cystoprostatectomy with orthotopic neobladder

2016 ◽  
Vol 57 (5) ◽  
pp. 364 ◽  
Author(s):  
Jung Kwon Kim ◽  
Min Chul Cho ◽  
Ja Hyeon Ku ◽  
Jae-Seung Paick
Keyword(s):  
Erectile Dysfunction ◽  
Penile Prosthesis ◽  
Orthotopic Neobladder ◽  
Radical Cystoprostatectomy ◽  
Inflatable Penile Prosthesis

Radical cystectomy and orthotopic neobladder in a patient with a preexisting three-components inflatable penile prosthesis

2021 ◽  
pp. 039156032110331
Author(s):  
Giacomo Rebez ◽  
Ottavia Runti ◽  
Michele Rizzo ◽  
Carlo Trombetta ◽  
Giovanni Liguori
Keyword(s):  
Erectile Dysfunction ◽  
Urothelial Carcinoma ◽  
Radical Cystectomy ◽  
Penile Prosthesis ◽  
Pelvic Surgery ◽  
Orthotopic Neobladder ◽  
Inflatable Penile Prosthesis ◽  
Oncologic Patients ◽  
Carcinoma Of The Bladder ◽  
Three Components

Introduction and objectives: As erectile dysfunction is more commonly being diagnosed and treated with a preexisting inflatable penile prosthesis (IPP) insertion at younger ages, surgeons will increasingly encounter pre-placed abdominal reservoirs when performing pelvic surgery. Materials and methods: A 69-year-old Caucasian man with BCG refractory carcinoma-in-situ (CIS) and past history of non-invasive high-grade urothelial carcinoma of the bladder was a candidate for a radical cystectomy and an ileal-neobladder diversion. He had a three-components IPP inserted for the treatment of Peyronie disease and organic erectile dysfunction (ED). During the radical cystectomy the reservoir was encapsulated on the left lateral pelvic wall over the external iliac vessels. It was isolated and IPP was inflated to reduce the reservoir size. After accurate disinfection, the reservoir was removed from Retzius space without disconnecting it from the pump. Then, the radical cystectomy was carried out without any intraoperative complications and Studer ileal orthotopic neobladder was performed. At the end of the surgery, the reservoir was disinfected with the Mulcahy protocol and then placed in the same position. Results: A week after catheter removal the IPP was successfully activated. The patient’s postoperative recovery was uneventful and no postoperative complication occurred. Definitive histological examination described a multifocal urothelial carcinoma of the bladder: pG3Tis N0 R0. The patient reports excellent functionality of the penile prosthesis and is currently using it. Conclusions: Sexual functionality preservation in oncologic patients should be pursued when possible. In this report, the functionality of the IPP was preserved, while still performing oncologically radical procedures. A multicenter study is needed to assure more solid recommendations on this rare procedure that is surely burdened by a lot of risks.

scholarly journals A purely penoscrotal approach: Reservoir placement of an inflatable penile prosthesis (IPP) in an orthotopic neobladder patient. Case report

2019 ◽  
Vol 91 (3) ◽  
Author(s):  
Cumhur Yeşildal ◽  
Ahmet Tevfik Albayrak ◽  
Abdullah Hizir Yavuzsan ◽  
Musab Ilgi ◽  
Sinan Levent Kireççi
Keyword(s):  
Erectile Dysfunction ◽  
Perioperative Complications ◽  
Surgical Techniques ◽  
Penile Prosthesis ◽  
Orthotopic Neobladder ◽  
Medical Treatments ◽  
Inflatable Penile Prosthesis ◽  
Estimated Blood Loss ◽  
Phosphodiesterase 5 ◽  
Erectile Dysfunction Treatment

Introduction: The inflatable penile prosthesis (IPP) is the last step in drug-resistant erectile dysfunction treatment. IPP implantation can be challenging, especially following a cystoprostatectomy with an orthotopic neobladder. There is no consensus about surgical techniques for placement of an IPP reservoir in such patients. In this paper, we present a case of an IPP and reservoir placement with a single penoscrotal incision. Case: A 55-year-old patient, who underwent radical cysto-prostatectomy with an orthotopic neobladder seven years ago, presented with severe erectile dysfunction. His oncologic status was stable, and he was in remission. He also had high blood pressure and took medication for it. He previously used different medical treatments, such as oral phosphodiesterase-5 inhibitors (PDE5i), intraurethral prostaglandin E2 (PGE2) installations, and Trimix injections. As far as we know, he had no benefit from these treatments. A three-piece IPP was recom- mended. After a discussion of surgical techniques, we chose the penoscrotal approach, and the ectopic reservoir was placed through the inguinal canal, guided by a forefinger. Results: The total operative time was 60 minutes, and the estimated blood loss was minimal. There were no perioperative complications. The patient was discharged on postoperative day one. He could start to use the IPP in the first month. His sexual and urinary functions were normal, and there was no abdominal bulging from the ectopic reservoir at the three-month follow-up.Conclusions: In conclusion, ectopic placement of the reservoir through a single penoscrotal incision appears to be a safe and acceptable surgical technique for postoperative ED following a radical cystoprostatectomy with an orthotopic neobladder.

scholarly journals An update on the best approaches to prevent complications in penile prosthesis recipients

2019 ◽  
Vol 11 ◽  
pp. 175628721881807 ◽  
Author(s):  
Sarah C. Krzastek ◽  
Ryan Smith
Keyword(s):  
Erectile Dysfunction ◽  
Patient Selection ◽  
Penile Prosthesis ◽  
Inflatable Penile Prosthesis ◽  
Device Implantation ◽  
Penile Prostheses ◽  
Operative Complications ◽  
Partner Satisfaction

Placement of inflatable penile prosthesis is a procedure frequently performed for medication-refractory erectile dysfunction. Device implantation is not without risks, and as the frequency of device implantation increases, so do associated complications. The aim of this work is to review the most frequent operative complications associated with implantation of inflatable penile prostheses, and to review the best approaches to prevent these most common complications. Complications can broadly be categorized as infectious, noninfectious tissue-related, device-related, or related to patient and partner satisfaction. With understanding of these complications and ways to avoid them, as well as with appropriate patient selection and counseling, the inflatable penile prosthesis is an excellent option for the treatment of erectile dysfunction.

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