The most challenging part of the inflatable penile prosthesis (IPP) is the reservoir placement (RP). There are several described surgical techniques of RP: intraabdominal implantation, extraperitoneal RP into the Space of Retzius (SR), and ectopic RP. The development of these techniques has a close historical relationship to the evolution of the IPP placement. In the prosthetic Urology this development is only possible because of parallel development and improvement of the IPP devices and their components including reservoirs. The traditional or so-called classis location for the reservoir is the prevesical space or SR location. Historically, the traditional location of the IPP reservoir was determined by the original inventor of the IPP, F. Brantley Scott and was a standard surgical technique in “English-speaking” countries, mostly in the USA. This method of RP was not a standard in “German-speaking” countries. This has less surgical but mostly historical background. As German German-certified urologist I primarily learned so-called “Prof. Schreiter way im RP”, who promoted a pelvic intraperitoneal location for the reservoir in the 1990s requiring a second suprainguinal incision. This method of RP is still widely spread in Germany, Austria, and Switzerland because of the similar surgical school in this region of Europe. In general, change a strategy or search for alternative surgical methods predestined by complications or bad outcome. The recent patient’s preference of minimally invasive robot-assisted surgery has led to increasing numbers of robotic-assisted prostatectomies, cystectomies, or rectum resections. Because the peritoneal veil is not restored after robotic surgery scar formation and adhesions in the space of Retzius hinder SR reservoir placement. Today, most high-volume implanters are using non-traditional reservoir location on a regular basis, and some have switched to it exclusively.

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Penile Prosthesis Reservoir Placement Strategies and Anchoring Technique

  • Daniar Osmonov

摘要

The most challenging part of the inflatable penile prosthesis (IPP) is the reservoir placement (RP). There are several described surgical techniques of RP: intraabdominal implantation, extraperitoneal RP into the Space of Retzius (SR), and ectopic RP. The development of these techniques has a close historical relationship to the evolution of the IPP placement. In the prosthetic Urology this development is only possible because of parallel development and improvement of the IPP devices and their components including reservoirs. The traditional or so-called classis location for the reservoir is the prevesical space or SR location. Historically, the traditional location of the IPP reservoir was determined by the original inventor of the IPP, F. Brantley Scott and was a standard surgical technique in “English-speaking” countries, mostly in the USA. This method of RP was not a standard in “German-speaking” countries. This has less surgical but mostly historical background. As German German-certified urologist I primarily learned so-called “Prof. Schreiter way im RP”, who promoted a pelvic intraperitoneal location for the reservoir in the 1990s requiring a second suprainguinal incision. This method of RP is still widely spread in Germany, Austria, and Switzerland because of the similar surgical school in this region of Europe. In general, change a strategy or search for alternative surgical methods predestined by complications or bad outcome. The recent patient’s preference of minimally invasive robot-assisted surgery has led to increasing numbers of robotic-assisted prostatectomies, cystectomies, or rectum resections. Because the peritoneal veil is not restored after robotic surgery scar formation and adhesions in the space of Retzius hinder SR reservoir placement. Today, most high-volume implanters are using non-traditional reservoir location on a regular basis, and some have switched to it exclusively.