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Inicio Actas Urológicas Españolas (English Edition) Three-piece inflatable penile prosthesis: Ectopic reservoir placement
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Vol. 44. Issue 5.
Pages 367-376 (June 2020)
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Vol. 44. Issue 5.
Pages 367-376 (June 2020)
Review article
Three-piece inflatable penile prosthesis: Ectopic reservoir placement
Prótesis de pene inflable de 3 componentes: emplazamiento ectópico del reservorio
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5
E. Martínez-Holguín
Corresponding author
emartinezh@salud.madrid.org

Corresponding author.
, E. Lledó-García, J. González, C. Hernández-Fernández
Servicio de Urología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
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Table 1. Results in terms of functional outcomes and complications of the main studies included in the review.
Abstract
Introduction

The complications associated to the placement of the reservoir are infrequent but potentially serious. Therefore, technical alternatives have been developed for the performance of the procedure in different locations (ectopic). The aim of this review is to revise the evidence available on the different options for the ectopic placement of the reservoir.

Material and method

Narrative review based on a bibliographical search limited to PubMed-indexed relevant manuscripts, in Spanish or English, for the period 2000–2019, using “penile prosthesis”, “ectopic reservoir”, radical prostatectomy”, “radical cystectomy”, “pelvic radiotherapy”, and “renal transplantation” as key words. Non original articles and reviews were not considered eligible. A total of 11 manuscripts were included.

Results

Pelvic alterations after surgery and/or radiotherapy increase the difficulty in the placement of the prosthesis reservoir. In order to minimize the risk of complications, different modifications have been performed on the devices, and technical innovations have been developed for the submuscular placement of the reservoir. The available evidence regarding the functionality and complications of these techniques is limited to single institution, low volume, and retrospective series with short follow-up periods. The functionality seems to be adequate using the adapted devices. The complications are infrequent and mild in severity.

Conclusions

Although the available evidence is still limited, the ectopic placement of the reservoir may be considered a safe, effective, and reproducible technique. In addition, it may result particularly useful in cases of altered pelvic anatomy.

Keywords:
Penile prosthesis
Ectopic reservoir
Radical prostatectomy
Radical cystectomy
Reservoir implant
Pelvic radiotherapy
Renal transplantation
Resumen
Introducción

Las complicaciones asociadas al emplazamiento del reservorio son infrecuentes pero pueden ser potencialmente graves, motivo por el cual se han desarrollado alternativas técnicas para el emplazamiento en lugares diferentes al habitual (ectópico). El objetivo de este trabajo es revisar, de acuerdo con la evidencia disponible, las diferentes opciones para el emplazamiento ectópico del reservorio.

Material y método

Revisión narrativa basada en una búsqueda bibliográfica de artículos relevantes indexados en PubMed, en inglés o castellano, publicados en el periodo 2000-2019, empleando las palabras clave: «prótesis de pene», «reservorio ectópico», «prostatectomía radical», «cistectomía radical», «radioterapia pélvica» y «trasplante renal». Se descartaron los artículos no originales, casos aislados y revisiones. Se revisaron un total de 11 trabajos.

Resultados

Las alteraciones de la anatomía de la pelvis tras cirugía o radioterapia generan una dificultad añadida al emplazamiento del reservorio. Para minimizar el riesgo de complicaciones se han modificado los dispositivos y las técnicas que permiten el emplazamiento submuscular. La evidencia relativa a funcionalidad y complicaciones se limita a series retrospectivas, de instituciones únicas, bajo volumen y escaso seguimiento. La funcionalidad es adecuada con los dispositivos adaptados; las complicaciones, infrecuentes y de escasa gravedad.

Conclusiones

Aunque la evidencia es baja, el emplazamiento ectópico del reservorio puede considerarse una técnica segura, eficaz y reproducible. Además, puede resultar particularmente útil en casos de anatomía pélvica alterada.

Palabras clave:
Prótesis de pene
Reservorio ectópico
Prostatectomía radical
Cistectomía radical
Colocación del reservorio
Radioterapia pélvica
Transplante renal

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