Advancements in ectopic reservoir placement for inflatable penile prostheses

Area of Science:

• Urology
• Andrology
• Surgical Innovation

Background:

• Traditional reservoir placement (RP) in penile prosthesis implantation risks serious complications like bladder, iliac vessel, and bowel injuries.
• Ectopic RP techniques have emerged to mitigate these risks.

Purpose of the Study:

• To provide a comprehensive analysis of ectopic reservoir placement techniques.
• To evaluate patient satisfaction and clinical complications associated with various ectopic RP methods.

Main Methods:

• A systematic literature search was conducted across PubMed, Ovid MEDLINE, and Cochrane Library (1966-2023).
• Keywords included "inflatable," "penile prosthesis," "reservoir," and "placement."
• Seventy publications were reviewed, comparing 12 retrospective studies detailing 9 ectopic RP techniques.

Main Results:

• Nine ectopic RP methods were analyzed: PTF/ATF, HSM, HSM-FST, LR, SEO, DVT, LSM w/ TFF, and MSMR.
• While rare, complications like bladder perforation, bowel obstruction, and colonic injury occurred.
• Herniation was a key concern, with no reported cases for LR, SEO, LSM w/ TFF, or MSMR.
• High patient satisfaction was noted for HSM, HSM-FST, and LSM w/ TFF, correlating with reservoir palpability/visibility.

Conclusions:

• Direct comparison of ectopic RP methods is limited by non-standardized patient surveys and inconsistent complication reporting.
• Larger sample sizes and prospective, multi-surgeon trials are necessary for robust evaluation.
• Further research is needed to establish optimal ectopic reservoir placement strategies.