Advertisement

Current Urology Reports

, 20:10 | Cite as

Damage Control Considerations During IPP Surgery

  • David Y. Yang
  • Tobias S. KohlerEmail author
Surgery (J Simhan, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Surgery

Abstract

Purpose of Review

This review summarizes the latest reports in inflatable penile prosthesis (IPP) complication management.

Recent Findings

IPP complications are rare, and reports are limited to retrospective studies. However, recent multi-institutional studies and use of national databases have provided further insight into risk factors for complications. Guidance on complication management is largely limited to techniques recommended by experts within the field.

Summary

American Urological Association guidelines place IPP implantation as a first line erectile dysfunction treatment. However, the majority of cases are performed by low-volume (≤ 4 cases/year) surgeons. Herein, we summarize the IPP literature and our personal experience to provide guidance on managing IPP complications.

Keywords

Complications Inflatable penile prosthesis Erectile dysfunction Outcomes 

Notes

Compliance with Ethical Standards

Conflict of Interest

David Y. Yang declares no potential conflicts of interest.

Tobias S. Kohler is a consultant for Coloplast and Boston Scientific.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    Capogrosso P, Pescatori E, Caraceni E, et al. Satisfaction rate at 1-year follow-up in patients treated with penile implants: data from the multicentre prospective registry INSIST-ED. BJU Int. 2018.Google Scholar
  2. 2.
    Henry GD, Kansal NS, Callaway M, Grigsby T, Henderson J, Noble J, et al. Centers of excellence concept and penile prostheses: an outcome analysis. J Urol. 2009;181:1264–8.CrossRefGoogle Scholar
  3. 3.
    Oberlin DT, Matulewicz RS, Bachrach L, Hofer MD, Brannigan RE, Flury SC. National practice patterns of treatment of erectile dysfunction with penile prosthesis implantation. J Urol. 2015;193:2040–4.CrossRefGoogle Scholar
  4. 4.
    •• Burnett AL, Nehra A, Breau RH, et al. Erectile dysfunction: AUA guideline. J Urol. 2018; Having a strong knowledge of current guideline recommendations is essential for appropriate patient workup, couseling and management.Google Scholar
  5. 5.
    Karpman E. Management of distal & proximal penile prosthesis crossover. J Sex Med. 2016;13:1008–12.CrossRefGoogle Scholar
  6. 6.
    • Antonini G, Busetto GM, Del Giudice F, et al. Distal corporal anchoring stitch: a technique to address distal corporal crossovers and impending lateral extrusions of a penile prosthesis. J Sex Med. 2017;14:767 This article describes a reproducable technique for managing impending lateral extrusion and distal corporal crossover.CrossRefGoogle Scholar
  7. 7.
    Stember DS, Kohler TS, Morey AF. Management of perforation injuries during and following penile prosthesis surgery. J Sex Med. 2015;12(Suppl 7):456.CrossRefGoogle Scholar
  8. 8.
    Trost L, Patil M, Kramer A. Critical appraisal and review of management strategies for severe fibrosis during penile implant surgery. J Sex Med. 2015;12(Suppl 7):439.CrossRefGoogle Scholar
  9. 9.
    Garber BB, Lim C. Inflatable penile prosthesis insertion in men with severe intracorporal fibrosis. Curr Urol. 2017;10:92.CrossRefGoogle Scholar
  10. 10.
    • Brant W, Köhler T, Henry G, Karpman E, Kansas B, Jones L, et al. “Unexpected” corporal fibrosis should be “expected”: the prevalence of significant corporal fibrosis encountered during penile prosthetics. J Sex Med. 2015;12 This abstract reported that even in "straight-forward" cases, corporal fibrosis requiring specialized techniques or instruments occurred in >25% of cases.Google Scholar
  11. 11.
    Levine LA, Rybak J. Traction therapy for men with shortened penis prior to penile prosthesis implantation: a pilot study. J Sex Med. 2011;8:2112–7.CrossRefGoogle Scholar
  12. 12.
    Tsambarlis PN, Chaus F, Levine LA. Successful placement of penile prostheses in men with severe corporal fibrosis following vacuum therapy protocol. J Sex Med. 2017;14:44–6.CrossRefGoogle Scholar
  13. 13.
    Canguven O, Talib RA, Campbell J, de Young L, el Ansari W, al-Ansari A. Is the daily use of vacuum erection device for a month before penile prosthesis implantation beneficial? A randomized controlled trial. Andrology. 2017;5:103–6.CrossRefGoogle Scholar
  14. 14.
    Anele UA, Le BV, Burnett AL. Suprapubic cystostomy for the management of urethral injuries during penile prosthesis implantation. Sex Med. 2014;2:178–81.CrossRefGoogle Scholar
  15. 15.
    Perito P. Urethral injury during inflatable penile prosthesis: a new repair. Video J Prosthet Urol. 2014;1.Google Scholar
  16. 16.
    Mulcahy JJ. The prevention and management of noninfectious complications of penile implants. Sex Med Rev. 2015;3:203–13.CrossRefGoogle Scholar
  17. 17.
    Levine LA, Becher EF, Bella AJ, et al. Penile prosthesis surgery: current recommendations from the international consultation on sexual medicine. J Sex Med. 2016;13:489–518.CrossRefGoogle Scholar
  18. 18.
    Pearlman AM, Terlecki RP. Proximal corporal perforation during penile prosthesis surgery: prevention, recognition, and review of historical and novel management strategies. J Sex Med. 2018;15:1055–60.CrossRefGoogle Scholar
  19. 19.
    Mulcahy JJ. Crural perforation during penile prosthetic surgery. J Sex Med. 2006;3:177–80.CrossRefGoogle Scholar
  20. 20.
    Knoll LD, Furlow WL. Corporeal reconstruction and prosthetic implantation for impotence associated with non-dilatable corporeal cavernosal fibrosis. Acta Urol Belg. 1992;60:15.PubMedGoogle Scholar
  21. 21.
    Wilson SK. Rear tip extender sling: a quick and easy repair for crural perforation. J Sex Med. 2010;7:1052–5.CrossRefGoogle Scholar
  22. 22.
    Caraceni E, Utizi L, Angelozzi G. Pseudo-capsule "coffin effect": how to prevent penile retraction after implant of three-piece inflatable prosthesis. Arch Ital Urol Androl. 2014;86:135–7.CrossRefGoogle Scholar
  23. 23.
    Kaufman JM, Weldon TE. Cylinder aneurysm of parylene-coated American Medical System (AMS) 700CX penile prosthesis. J Sex Med. 2008;5:2713–5.CrossRefGoogle Scholar
  24. 24.
    • Wilson SK, Mora-Estaves C, Egydio P, et al. Glans necrosis following penile prosthesis implantation: prevention and treatment suggestions. Urology. 2017;107:144 This article is the only article that summarizes all previous reports of glans necrosis and highlights the need for immediate device explantation.CrossRefGoogle Scholar
  25. 25.
    Perito P, Wilson S. The history of nontraditional or ectopic placement of reservoirs in prosthetic urology. Sex Med Rev. 2016;4:190–3.CrossRefGoogle Scholar
  26. 26.
    Ziegelmann MJ, Viers BR, Lomas DJ, Westerman ME, Trost LW. Ectopic penile prosthesis reservoir placement: an anatomic cadaver model of the high submuscular technique. J Sex Med. 2016;13:1425–31.CrossRefGoogle Scholar
  27. 27.
    Clavell Hernandez J, Trost L, Kohler T, et al. Emerging complications following alternative reservoir placement during inflatable penile prosthesis placement: a 5-year multi-institutional experience. J Urol. 2018.Google Scholar
  28. 28.
    • Henry G, Hsiao W, Karpman E, et al. A guide for inflatable penile prosthesis reservoir placement: pertinent anatomical measurements of the retropubic space. J Sex Med. 2014;11:273 This article provides objective measurments demostrating that vital structures within the pelvis are suprising close to the ring but can be protected with use of bladder decompression and trendelenberg positioning.CrossRefGoogle Scholar
  29. 29.
    Capoccia EM, Phelps JN, Levine LA. Modified inflatable penile prosthesis reservoir placement into space of retzius: comparing outcomes in men with or without prior pelvic surgery. J Sex Med. 2017;14:968–73.CrossRefGoogle Scholar
  30. 30.
    Lane BR, Abouassaly R, Angermeier KW, Montague DK. Three-piece inflatable penile prostheses can be safely implanted after radical prostatectomy through a transverse scrotal incision. Urology. 2007;70:539–42.CrossRefGoogle Scholar
  31. 31.
    Vollstedt A, Gross MS, Antonini G, Perito PE. The infrapubic surgical approach for inflatable penile prosthesis placement. Transl Androl Urol. 2017;6:620–7.CrossRefGoogle Scholar
  32. 32.
    Kramer AC, Chason J, Kusakabe A. Report of two cases of bladder perforation caused by reservoir of inflatable penile prosthesis. J Sex Med. 2009;6:2064–7.CrossRefGoogle Scholar
  33. 33.
    Garber BB, Morris A. Intravesical penile implant reservoir: case report, literature review, and strategies for prevention. Int J Impot Res. 2013;25:41–4.CrossRefGoogle Scholar
  34. 34.
    Brison D, Ilbeigi P, Sadeghi-Nejad H. Reservoir repositioning and successful thrombectomy for deep venous thrombosis secondary to compression of pelvic veins by an inflatable penile prosthesis reservoir. J Sex Med. 2007;4:1185–7.CrossRefGoogle Scholar
  35. 35.
    da Justa DG, Bianco FJ Jr, Ogle A, Dhabuwala CB. Deep venous thrombosis due to compression of external iliac vein by the penile prosthesis reservoir. Urology. 2003;61:462.CrossRefGoogle Scholar
  36. 36.
    Cefalu CA, Deng X, Zhao LC, Scott JF, Mehta S, Morey AF. Safety of the "drain and retain" option for defunctionalized urologic prosthetic balloons and reservoirs during artificial urinary sphincter and inflatable penile prosthesis revision surgery: 5-year experience. Urology. 2013;82:1436–9.CrossRefGoogle Scholar
  37. 37.
    Wilson SK, Cleves M, Delk JR. Scrotal hematoma prevention following penile prosthesis implantation: to drain or not to drain. J Urol. 1996;155:634A.CrossRefGoogle Scholar
  38. 38.
    • Sadeghi-Nejad H, Ilbeigi P, Wilson SK, et al. Multi-institutional outcome study on the efficacy of closed-suction drainage of the scrotum in three-piece inflatable penile prosthesis surgery. Int J Impot Res. 2005;17:535 This retrospective study demonstrates the minimal risk of infection and hematoma when using closed suction scrotal drains post-operatively.CrossRefGoogle Scholar
  39. 39.
    Wilson SK, Costerton JW. Biofilm and penile prosthesis infections in the era of coated implants: a review. J Sex Med. 2012;9:44–53.CrossRefGoogle Scholar
  40. 40.
    Darouiche RO, Wall MJ Jr, Itani KM, et al. Chlorhexidine-alcohol versus povidone-iodine for surgical-site antisepsis. N Engl J Med. 2010;362:18–26.CrossRefGoogle Scholar
  41. 41.
    Mandava SH, Serefoglu EC, Freier MT, Wilson SK, Hellstrom WJG. Infection retardant coated inflatable penile prostheses decrease the incidence of infection: a systematic review and meta-analysis. J Urol. 2012;188:1855–60.CrossRefGoogle Scholar
  42. 42.
    Eid JF. Penile implant: review of a "no-touch" technique. Sex Med Rev. 2016;4:294–300.CrossRefGoogle Scholar
  43. 43.
    Zargaroff S, Sharma V, Berhanu D, et al. National trends in the treatment of penile prosthesis infections by explantation alone vs. immediate salvage and reimplantation. J Sex Med. 2014;11:1078.CrossRefGoogle Scholar
  44. 44.
    • Lopategui DM, Balise RR, Bouzoubaa LA, et al. The impact of immediate salvage surgery on corporeal length preservation in patients presenting with penile implant infections. J Urol. 2018;200:171 This study highlights the significant difference in penile length in patients treated with immediate salvage surgery following implant infection. CrossRefGoogle Scholar
  45. 45.
    Mulcahy JJ. Long-term experience with salvage of infected penile implants. J Urol. 2000;163:481–2.CrossRefGoogle Scholar
  46. 46.
    • Gross MS, Phillips EA, Balen A, et al. The malleable implant salvage technique: infection outcomes after mulcahy salvage procedure and replacement of infected inflatable penile prosthesis with malleable prosthesis. J Urol. 2016;195:694 This multi-center study discusses the use of MIST technique for salvaging infected IPP with use of a malleable device.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of UrologyMayo ClinicRochesterUSA

Personalised recommendations