Mediathek

Erosion of inflatable penile prothesis reservoir into the bladder: managed by reservoir placement at a higher level of sub-rectus abdominal wall

Schlagworte: Diagnostik
04.11.2021Deutsch

Abstract

Erosion of inflatable penile prothesis reservoir into the bladder: managed by reservoir placement at a higher level of sub-rectus abdominal wall

M. Mahdi1, R. Talib1, M. Alwani2, O. Aboumarzouk1, R. Al-Zoubi1, A. Qudimat1, A. Yassin1,3
1Hamad Medical Corporation, Doha, Katar, 2Jordan University of Science and Technology, Irbid, Jordanien, 3Segeberger Kliniken, Norderstedt, Norderstedt b. Hamburg, Deutschland

Objective: A 64 year old diabetic patient, presented to our clinic suffering from erectile dysfunction (ED). A 3-pieces of inflatable penileprosthesis (IPP) was inserted. He was satisfied and used the device efficiently.Patient suffered from a minor lower abdominal blunt trauma. Followed by a suddenonset of lower abdominal pain and gross hematuria, the pain subsided later. Also, he suffered from irritative and obstructive lower urinary tract symptoms (LUTS)associated with intermittent hematuria for 2 months, before seeking medical care. During that period he was using the device without any difficulty.On examination,no signs of infection was discovered, with normal device inflation and deflation. A flexible cystoscopy showed the reservoir is completely inside the bladder
Methods: A revision procedure was done, staring with lower midline abdominal incision, identifying the bladder, cystostomy and removing of the erodedreservoir, then a cystorrhaphy, and finally insertion of a concealed reservoir between the anterior rectus sheath and rectus muscle at a higher level of theabdominal wall contralaterally due to inflamed retzius space at the contralateral side, as the video demonstrates.
Results: Postoperatively, the device was working seamlessly with normal inflating and deflating, recovery was uneventful.At the 10th day, a cystogram wasdone with no contrast extravasation. At the follow-up, the patient was satisfied and used the device efficiently with no observed complications.
Conclusions: Eroded Inflatable Penile Prothesis (IPP) reservoir can be safely replaced in a single procedure with the absence of complications. Nontraditional placement of IPP reservoir is a good alternative especially in case of hostile pelvis or retzius

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