(173) SINGLE SURGEON EXPERIENCE WITH RESERVOIR PLACEMENT DURING PENOSCROTAL INFLATABLE PENILE IMPLANT SURGERY, IS A COUNTER INCISION NECESSARY

Abstract Introduction Reservoir placement during penoscrotal inflatable penile implant surgery (IPP) can be done via the primary incision or through a separate lower abdominal incision. Surgeons that do routine secondary incisions state risks of vascular, bowel or bladder injury. There is a distinct advantage in avoiding a secondary incision in terms of pain, added surgical times and possible wound infections. Objective I decided to review my cases over the last several years to determine the number of times a counter incision was necessary and to determine the true incidence of such stated risk factors. To help young surgeons determine the risks of reservoir placement in a real-world experience. Methods IPP done between 2008 and 2023 were retrospectively reviewed to determine frequency of counter incision and rates of complications due to reservoir placement. All IPP were performed by a single surgeon utilizing the penoscrotal approach. Results A total of 4,589 IPP were performed, 4223 Virgin and 366 removal and replacement. The first 3778 cases had the reservoir placed in the space of Retzius the next 611 done ectopically and the last 200 by a medially placed submuscular approach. One (0.02%) case of bladder injury was identified in the early ectopic experience, treated with catheter placement and contralateral reservoir placement. In 8 (0.17%) patients the reservoir herniated and needed replacement. None in the new approach. No cases of bowel or vascular injury were encountered. New reservoir placement technique is achieved in less than 1 minute. None of the cases required a counter incision. Conclusions Reservoir placement during penoscrotal IPP without a counter incision, is an extremely safe and efficient technique. We should encourage the new generation implanters to properly learn this approach and not scare them with rarely seen potential complications. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Boston Scientific.