Outcomes of lateral retroperitoneal reservoir placement of three-piece penile prosthesis in patients following radical prostatectomy

Abstract

While placement of a three-piece inflatable penile prosthesis (IPP) with a midline reservoir can be performed with favorable outcomes after radical prostatectomy (RP), postoperative fascial scarring can introduce surgical complexity, increase intra-operative complications and/or potential obstacles for future inguinal and/or perineal surgeries. We describe the implantation of the IPP with lateral reservoir placement through a separate incision to avoid surgical complications. We obtained clinical characteristics of all patients (1998–2009) who underwent RP before IPP placement with lateral reservoir placement (cases). For comparison, patients who underwent IPP placement with midline reservoir placement were also identified (controls). Thirty-one patients with a history of RP underwent IPP placement using the lateral placement technique without intra-operative or post-operative complications. There were no significant differences in the intra-operative complication rate among 31 control patients. However, at a median follow-up of >2 years, there was a significantly higher rate of post-operative complications in controls, likely reflecting the increased co-morbidities in this group. The results of this study suggest that three-piece IPP with lateral retroperitoneal reservoir implantation is associated with comparable long-term outcomes and can be performed safely in patients who have previously undergone RP.