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High Submuscular IPP Reservoir Placement: The "Five-Step" Technique
Adam S Baumgarten1, Mehraban Kavoussi1, Nicolas M Ortiz1
1Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX.
Urology
|August 9, 2020
Summary
The Five-Step Technique (FST) for high submuscular (HSM) placement of inflatable penile prosthesis (IPP) reservoirs is safe and effective, preventing deep pelvic complications. Patients report high satisfaction and no reservoir palpability, making it a recommended procedure.
Area of Science:
- Urology
- Surgical Techniques
- Medical Devices
Background:
- High submuscular (HSM) placement of inflatable penile prosthesis (IPP) reservoirs offers an alternative to traditional space of Retzius placement.
- A refined "Five-Step" Technique (FST) was developed in 2014 to mitigate deep pelvic complications associated with HSM reservoir placement.
Discussion:
- The FST involves five distinct steps: Position and Access, Lower HSM Pocket Development, Upper HSM Pocket Development, Reservoir Delivery, and Confirmation and Connection.
- Retrospective data from January 2014 to June 2019 included 297 consecutive HSM IPP reservoir placements using the FST.
- A patient satisfaction survey was conducted among 100 randomly selected individuals.
Key Insights:
- The FST resulted in a low surgical revision rate (1.0%) primarily for herniation, with no reported deep pelvic complications.
- Post-procedure, 86% of patients reported no reservoir palpability.
- An overwhelming 95% of patients expressed satisfaction and willingness to recommend the procedure.
Outlook:
- The FST for HSM reservoir placement is a straightforward and secure method for inflatable penile prosthesis procedures.
- This technique demonstrates efficacy in preventing serious pelvic complications.
- High patient satisfaction rates suggest the FST is a valuable advancement in IPP surgery.
