A review of the safety and efficacy of inflatable penile prosthesis ectopic reservoir placement

Britney Atwater; Aaron Krug; Martin S Gross; Robyn Marty-Roix; Laura Chapin; Allen F Morey

doi:10.1093/sxmrev/qeae067

A review of the safety and efficacy of inflatable penile prosthesis ectopic reservoir placement

Sex Med Rev. 2024 Nov 1:qeae067. doi: 10.1093/sxmrev/qeae067. Online ahead of print.

Authors

Britney Atwater¹, Aaron Krug², Martin S Gross¹, Robyn Marty-Roix³, Laura Chapin³, Allen F Morey²

Affiliations

¹ Section of Urology, Dartmouth Hitchcock Medical Center, Lebanon, NH 03766, United States.
² Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX 75390, United States.
³ Boston Scientific Corporation, Marlborough, MA 01753, United States.

PMID: 39487491
DOI: 10.1093/sxmrev/qeae067

Abstract

Introduction: Patient medical and surgical history factors, such as prior prostatectomy, may lead surgeons to opt for ectopic reservoir placement rather than the standard reservoir location in the retropubic space (RPS) during inflatable penile prosthesis (IPP) placement.

Objective: To examine the safety and effectiveness of ectopic reservoir placement used with three-piece IPPs in relation to reservoir placement in the RPS.

Methods: A systematic review of MEDLINE/Pubmed and Embase databases was performed for literature between 1970 and 2022. Clinical studies and case reports describing three-piece IPP reservoir placement and clinical outcomes on AMS 700, similar products (such as Coloplast Titan), and three-piece IPPs where the manufacturer is not specified were included.

Results: Seventy articles were identified that reported clinical outcomes on three-piece IPP reservoir placement, which included data on 9565 patients. Of these, 67% of the reservoirs (n = 6413) were placed in ectopic locations. These locations were defined as submuscular (n = 5207), retroperitoneal (n = 405), sub-external oblique (n = 50), peritoneal (n = 42), subcutaneous (n = 10), and did not specify the ectopic location (n = 694). A total of 670 patients had ectopic placement of the AMS 700 reservoirs specifically. Overall, there were no elevated rates in safety outcomes between RPS and ectopic placement. Fourteen studies directly compared safety and/or efficacy outcomes between RPS and ectopic placement and did not report any significant differences between patient groups.

Conclusions: Ectopic reservoir placement of three-piece IPPs, including AMS 700, is comparable in terms of safety, efficacy, and patient satisfaction to RPS reservoir placement. Ectopic reservoir placement of the AMS 700 device is also similarly comparable to ectopically placed reservoirs of other IPPs as reported in the literature. Surgeons should consider ectopic implantation for patients at higher risk of complications associated with reservoir placement into the RPS.

Keywords: ectopic reservoir; inflatable penile prosthesis; penile prosthesis; safety.

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