{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T10:19:42Z","timestamp":1781777982608,"version":"3.54.5"},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2018,2,13]],"date-time":"2018-02-13T00:00:00Z","timestamp":1518480000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"},{"start":{"date-parts":[[2018,2,13]],"date-time":"2018-02-13T00:00:00Z","timestamp":1518480000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"content-domain":{"domain":["jsm.jsexmed.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2018,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>After radical cystoprostatectomy (RC), postoperative erectile dysfunction (ED) is a common consequence with multiple contributing etiologies. The inflatable penile prosthesis (IPP) offers patients a definitive treatment option when ED is refractory to medical therapies. Because of the hostile postoperative anatomy of these patients, a careful surgical approach is necessary for successful outcomes and to avoid adjacent organ injury. To date, there is no series describing the outcomes of 3-piece IPP placement in patients with urinary diversions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aim<\/jats:title>\n                  <jats:p>To present contemporary outcomes and a description of our technique in placing a 3-piece IPP for postoperative ED in patients with a history of RC with orthotopic neobladder, ileal conduit, or continent cutaneous diversion.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We retrospectively reviewed 80 patients who underwent primary placement of a 3-piece IPP (AMS 700; American Medical Systems Inc, Minnetonka, MN, USA) after RC and urinary diversion from 2003 through 2016. 79 patients underwent RC in their treatment of urologic malignancy (71 for bladder cancer, 8 for prostate cancer) and 1 underwent RC for refractory interstitial cystitis. An infrapubic approach was used in most patients, with reservoir placement in the lateral retroperitoneal space through a counterincision medial to the anterior superior iliac spine. Patient demographics, perioperative data, and postoperative outcomes including prosthetic infection and mechanical failure were examined and statistical analysis was performed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Outcomes<\/jats:title>\n                  <jats:p>Rates of device infection, revision surgery, and reservoir complications.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>After mean follow-up of 53.9 months (6.5\u2013150.7 months), 4 patients developed infection of the prosthesis that required explantation. 3 of those patients underwent successful IPP reimplantation. 5 patients required revision surgery (pump replacement, n\u00a0= 3; pump relocation, n\u00a0= 1; cylinder replacement for cylinder aneurysm, n\u00a0= 1) for mechanical failure. No statistically significant associations were found between infection and comorbidities, urinary diversion, exposure to chemotherapy, radiation, or presence of an artificial urinary sphincter.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical Implications<\/jats:title>\n                  <jats:p>The 3-piece IPP is an effective treatment option for medication-refractory ED that can be placed safely in patients with all forms of urinary diversion.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Strengths and Limitations<\/jats:title>\n                  <jats:p>This study represents the 1st series that describes a successful technique and long-term outcomes of patients with urinary diversion. It is limited by its single-surgeon, single-center experience and lacks validated patient satisfaction data in follow-up.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The 3-piece IPP, with reservoir placement in the lateral retroperitoneum, can be implanted successfully in patients with all forms of urinary diversion without a significant increase in infectious complications, reservoir erosion, or mechanical failure.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1016\/j.jsxm.2018.01.014","type":"journal-article","created":{"date-parts":[[2018,2,13]],"date-time":"2018-02-13T17:48:05Z","timestamp":1518544085000},"page":"907-913","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":29,"title":["3-Piece Inflatable Penile Prosthesis Placement Following Radical Cystoprostatectomy and Urinary Diversion: Technique and Outcomes"],"prefix":"10.1093","volume":"15","author":[{"given":"Jeffrey","family":"Loh-Doyle","sequence":"first","affiliation":[{"name":"USC Institute of Urology , Los Angeles, CA , USA"},{"name":"USC\/Norris Comprehensive Cancer Center , Los Angeles, CA , USA"},{"name":"Keck School of Medicine , Los Angeles, CA , USA"},{"name":"University of Southern California , Los Angeles, CA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mukul B.","family":"Patil","sequence":"additional","affiliation":[{"name":"Tricounty Urology Associates , Washington, PA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hari","family":"Sawkar","sequence":"additional","affiliation":[{"name":"USC Institute of Urology , Los Angeles, CA , USA"},{"name":"USC\/Norris Comprehensive Cancer Center , Los Angeles, CA , USA"},{"name":"Keck School of Medicine , Los Angeles, CA , USA"},{"name":"University of Southern California , Los Angeles, CA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Wayne","sequence":"additional","affiliation":[{"name":"USC Institute of Urology , Los Angeles, CA , USA"},{"name":"USC\/Norris Comprehensive Cancer Center , Los Angeles, CA , USA"},{"name":"Keck School of Medicine , Los Angeles, CA , USA"},{"name":"University of Southern California , Los Angeles, CA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stuart D.","family":"Boyd","sequence":"additional","affiliation":[{"name":"USC Institute of Urology , Los Angeles, CA , USA"},{"name":"USC\/Norris Comprehensive Cancer Center , Los Angeles, CA , USA"},{"name":"Keck School of Medicine , Los Angeles, CA , USA"},{"name":"University of Southern California , Los Angeles, CA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2018,2,13]]},"reference":[{"key":"2023012309264211200_bib1","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/j.urology.2015.12.079","article-title":"Recent trends in postcystectomy health-related quality of life favors neobladder diversion: systematic review of the literature","volume":"93","author":"Ghosh","year":"2016","journal-title":"Urology"},{"key":"2023012309264211200_bib2","first-page":"297","article-title":"Erosion of an inflatable penile prosthesis reservoir into an ileal conduit","volume":"137","author":"Godiwalla","year":"1986","journal-title":"J\u00a0Urol"},{"key":"2023012309264211200_bib3","first-page":"2343","article-title":"Erosion of inflatable penile prosthesis reservoir into neobladder","volume":"10","author":"Tran","year":"2013","journal-title":"J\u00a0Sex Med"},{"key":"2023012309264211200_bib4","first-page":"336","article-title":"Unilateral 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Published by Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}