The utility of lockout valve reservoirs in preventing autoinflation in penile prostheses

Abstract

Introduction: Autoinflation is a troublesomecomplication following penile prosthesisplacement that may be potentiated by prevesicalscarring following radical prostatectomy. Weevaluated the frequency of autoinflation andother complications following penile prosthesisplacement in radical prostatectomy patients andcontrols as a surrogate to establishing theutility of lockout reservoirs in preventingautoinflation.Methods: 139 prostheses (including 14with lockout reservoirs) were placed in 132 men(including 35 post-prostatectomy patients) overa 5¹/₂ year period at our institution. Outcomesassessed include postoperative complicationsand the need for revision or replacement of theprosthesis. Multivariable regression analysiswas used to determine the association ofpatient, device-specific, and perioperativecharacteristics with these outcomes.Results: There was no difference in thepostoperative complication and re-operationrates between post-prostatectomy patients andcontrols (both p > 0.77). The incidence ofautoinflation in post-prostatectomy patientsand controls was 3% and 5%, respectively(p > 0.99). Patients with prior prostheseswere 3 times as likely to develop apostoperative complication or requireprosthesis revision (p = 0.02).Conclusion: Penile prostheses are welltolerated in post-prostatectomy patients withcomparable outcomes to those men with organicerectile dysfunction. The frequency ofautoinflation does not appear to be increasedin post-prostatectomy patients. Initialresults with the lockout valve reservoir inpreventing autoinflation are encouraging thoughadditional study is warranted to justify theirroutine use.