High Submuscular IPP Reservoir Placement: The “Five-Step” Technique

Adam S. Baumgarten, Mehraban Kavoussi, Nicolas M. Ortiz, Roger K. Khouri, Ellen E. Ward, Steven J. Hudak, Allen F. Morey

Research output: Contribution to journalArticle

Abstract

Background: High submuscular (HSM) placement of inflatable penile prosthesis (IPP) reservoirs is a promising new FDA approved alternative to traditional space of Retzius reservoir placement. In 2011, we began placing all reservoirs in a HSM position at our tertiary center. In 2014, we proposed a refined, “Five-Step” HSM reservoir placement technique (FST) to prevent deep pelvic complications. Objectives: To describe our HSM technique and report on our extended experience. Material: Our refined FST was developed to optimize outcomes and includes the following steps: (1) Position and Access; (2) Develop Lower HSM Pocket; (3) Develop Upper HSM Pocket; (4) Reservoir Delivery (Fill and Fine-Tune); (5) Confirm and Connect. Data was retrospectively collected on patients undergoing reservoir placement by FST between January 2014 and June 2019. A survey analyzing subjective outcomes and patient satisfaction was performed among 100 randomly selected patients. Results: We placed 297 consecutive HSM IPP reservoirs via FST during this time period. Three patients (1.0%) required surgical revision (all for herniation). No deep pelvic (vascular, bladder, bowel) complications were reported. Of the 100 patients that were randomly surveyed, 86% of patients reported no palpability of the reservoir, and 95% of patients reported satisfaction with the procedure and would recommend the procedure to a friend. Conclusion: The FST for HSM reservoir placement is a simple and safe procedure with good outcomes and excellent patient satisfaction. This technique appears to effectively eliminate the risks of deep pelvic complications.

Original languageEnglish (US)
JournalUrology
DOIs
StateAccepted/In press - 2020
Externally publishedYes

ASJC Scopus subject areas

  • Urology

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    Baumgarten, A. S., Kavoussi, M., Ortiz, N. M., Khouri, R. K., Ward, E. E., Hudak, S. J., & Morey, A. F. (Accepted/In press). High Submuscular IPP Reservoir Placement: The “Five-Step” Technique. Urology. https://doi.org/10.1016/j.urology.2020.07.039