{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T12:03:27Z","timestamp":1770897807460,"version":"3.50.1"},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2024,9,13]],"date-time":"2024-09-13T00:00:00Z","timestamp":1726185600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,10,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The 3-piece inflatable penile prosthesis (IPP) is the most widely used device for erectile dysfunction refractory to medications, containing a reservoir inserted into the retropubic space (RPS) or an alternative\/ectopic space (AES). Indications for removal of the reservoir include malfunction, malposition, or infection. In revision cases without infection, reservoir removal is sometimes optional.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aim<\/jats:title>\n                  <jats:p>We reviewed outcomes and complications related to reservoir removal from a large multi-institutional series.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We retrospectively reviewed databases at 6 institutions over 7\u00a0years. Patients with artificial urethral sphincter, urethral sling, or mini-jupette were excluded.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Outcomes<\/jats:title>\n                  <jats:p>Outcomes and complications related to IPP reservoir removal were analyzed. Data were collected, but only reservoir-related complications at surgery were included. Data were compared between the RPS and AES cohorts to evaluate differences with a \u03c72 test, with significance at P &amp;lt; .05.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 215 cases, there were 172 RPS and 43 AES reservoirs. The mean patient age was 65.3\u00a0years. An overall 131 procedures were due to malfunction and 49 to malposition of an IPP component; 35 were secondary to infection. Among those retained (n\u2009=\u200944), reasons included reuse, avoiding surrounding structure damage, and difficult dissection. Among those removed (n\u2009=\u2009171), 15 required a counterincision. To determine the statistical difference between those removed from the RPS and an AES, the \u03c72 test result was P = .00059, indicating a significant difference in the need for a counterincision between the groups. Complications included bladder perforation (n\u2009=\u20091) in the RPS group and an avulsion of the epigastric vessels requiring abdominal exploration (n\u2009=\u20091) in the AES group. To determine the statistical difference between RPS and AES complications, the \u03c72 test result was P = .365, indicating no significant difference between the groups.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Strengths and Limitations<\/jats:title>\n                  <jats:p>Strengths include being a multi-institutional study with high-volume skilled implanters. Limitations include being a retrospective review, with implanters exclusively performing penoscrotal incisions and not utilizing an infrapubic approach. Last, there was a lack of long-term follow-up with these patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Removal of an IPP reservoir remains safe, with few intraoperative complications. Surgeons should be aware of the inferior epigastric vessels during removal in an AES or be willing to perform a counterincision to avoid injury to surrounding structures. Surgeons should also obtain preoperative imaging to identify the specific location of the reservoir and adjacent anatomy. This is the first multi-institutional study reviewing outcomes related to reservoir removal during IPP revision or removal surgery.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jsxmed\/qdae112","type":"journal-article","created":{"date-parts":[[2024,9,14]],"date-time":"2024-09-14T08:35:12Z","timestamp":1726302912000},"page":"1076-1080","source":"Crossref","is-referenced-by-count":2,"title":["Outcomes related to penile prosthesis reservoir removal: a 7-year multi-institutional experience"],"prefix":"10.1093","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4162-4672","authenticated-orcid":false,"given":"Javier","family":"Piraino","sequence":"first","affiliation":[{"name":"Carolina Urology Partners , Charlotte, NC 28210,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian","family":"Madison","sequence":"additional","affiliation":[{"name":"Division of Urology , Main Line Health, Wynnewood, PA 19096,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dylan","family":"Supak","sequence":"additional","affiliation":[{"name":"Division of Urology , University of Texas McGovern Medical School, Houston, TX 77030,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Landon","family":"Trost","sequence":"additional","affiliation":[{"name":"Male Infertility and Peyronie\u2019s Clinic , Orem, UT 84057,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert J","family":"Cornell","sequence":"additional","affiliation":[{"name":"Robert J Cornell MD PA , Houston, TX 77002,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tobias","family":"Kohler","sequence":"additional","affiliation":[{"name":"Department of Urology , Mayo Clinic, Rochester, MN 55902,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerard D","family":"Henry","sequence":"additional","affiliation":[{"name":"Willis-Knighton Health Advanced Urology , Shreveport, LA 71115,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aram B","family":"Loeb","sequence":"additional","affiliation":[{"name":"University Hospitals Urology Institute , Beachwood, OH 44122,","place":["United States"]},{"name":"Department of Urology , Case Western Reserve University, Cleveland, OH 44106,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Run","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Urology , University of Texas McGovern Medical School, Houston, TX 77030,","place":["United States"]},{"name":"Department of Urology , University of Texas MD Anderson Cancer Center, Houston, TX 77030,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Clavell Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Division of Urology , University of Texas McGovern Medical School, Houston, TX 77030,","place":["United States"]},{"name":"Vitality Urology Institute , Inc. 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