TY - JOUR
T1 - High Submuscular Placement of Urologic Prosthetic Balloons and Reservoirs via Transscrotal Approach
AU - Morey, Allen F.
AU - Cefalu, Christopher A.
AU - Hudak, Steven J.
N1 - Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2013/2
Y1 - 2013/2
N2 - Introduction. Traditional placement of inflatable penile prosthesis (IPP) reservoirs and/or artificial urinary sphincter (AUS) balloons into the space of Retzius may be challenging following major pelvic surgery. Aim. The aim of this study is to report our 1-year experience using a novel technique for high balloon/reservoir placement beneath the rectus abdominus muscle, thus completely obviating deep pelvic dissection during prosthetic urologic surgery. Methods. A retrospective review of all patients who underwent IPP and/or AUS placement between June 2011 and June 2012 was performed. All had AUS balloons and/or IPP reservoirs placed in a submuscular location by bluntly tunneling through the external inguinal ring into a potential space between the transversalis fascia and the rectus abdominus muscle using a long, angled, lung grasping clamp. Main Outcome Measures. Patient demographics, perioperative outcomes, and initial follow-up patient-reported outcomes were reviewed. Results. During the study period, 120 submuscular balloons/reservoirs were inserted in 107 consecutive patients who underwent placement of an IPP (61 patients), AUS (33 patients), or both (13 patients). Among our 48 most recent patients, 41 (85%) reported they were totally unable to feel their balloon/reservoir, and all but two patients reported no bother from the submuscular balloon/reservoir placement. Of the 120 total submuscular balloons and reservoirs, surgical time and outcomes of the prosthetic procedures appeared similar to those placed using traditional methods; two reservoirs required revision surgery for repositioning. Conclusions. High submuscular placement of genitourinary prosthetic balloons and reservoirs via a transscrotal approach is both safely and effective, while avoiding deep retropubic dissection.
AB - Introduction. Traditional placement of inflatable penile prosthesis (IPP) reservoirs and/or artificial urinary sphincter (AUS) balloons into the space of Retzius may be challenging following major pelvic surgery. Aim. The aim of this study is to report our 1-year experience using a novel technique for high balloon/reservoir placement beneath the rectus abdominus muscle, thus completely obviating deep pelvic dissection during prosthetic urologic surgery. Methods. A retrospective review of all patients who underwent IPP and/or AUS placement between June 2011 and June 2012 was performed. All had AUS balloons and/or IPP reservoirs placed in a submuscular location by bluntly tunneling through the external inguinal ring into a potential space between the transversalis fascia and the rectus abdominus muscle using a long, angled, lung grasping clamp. Main Outcome Measures. Patient demographics, perioperative outcomes, and initial follow-up patient-reported outcomes were reviewed. Results. During the study period, 120 submuscular balloons/reservoirs were inserted in 107 consecutive patients who underwent placement of an IPP (61 patients), AUS (33 patients), or both (13 patients). Among our 48 most recent patients, 41 (85%) reported they were totally unable to feel their balloon/reservoir, and all but two patients reported no bother from the submuscular balloon/reservoir placement. Of the 120 total submuscular balloons and reservoirs, surgical time and outcomes of the prosthetic procedures appeared similar to those placed using traditional methods; two reservoirs required revision surgery for repositioning. Conclusions. High submuscular placement of genitourinary prosthetic balloons and reservoirs via a transscrotal approach is both safely and effective, while avoiding deep retropubic dissection.
KW - Artificial urinary sphincter
KW - Erectile dysfunction
KW - Penile prosthesis
KW - Urinary incontinence
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U2 - 10.1111/jsm.12000
DO - 10.1111/jsm.12000
M3 - Article
C2 - 23216955
AN - SCOPUS:84873058504
SN - 1743-6095
VL - 10
SP - 603
EP - 610
JO - Journal of Sexual Medicine
JF - Journal of Sexual Medicine
IS - 2
ER -