Spontaneous Erosion of a 15-Year-Old Retained Inflatable Penile Prosthesis Reservoir Into the Bladder: A Case Report and Literature Review

In the absence of infection, the reservoir of a malfunctioning three-piece inflatable penile prosthesis (IPP) is often left in place during replacement. Experts believe that the risks associated with reservoir explantation outweigh the risks of a drain-and-retain approach. However, there is no clear consensus on monitoring. The objective of this case report is to highlight the need for vigilance regarding long-term potential complications associated with retained reservoirs, as this report describes a retained reservoir eroding spontaneously into the bladder 15 years post-placement in a 69-year-old man. The patient had been reporting gross hematuria, recurrent UTIs, and worsened lower urinary tract symptoms (LUTS). CT imaging, followed by cystoscopy, demonstrated the decommissioned reservoir in the bladder. The patient then underwent exploratory laparotomy and bladder exploration to remove the eroding reservoir and replace the functional three-piece IPP with a malleable one. By reviewing the available literature, we found three clinical scenarios using variable clinical approaches to deal with bladder erosion by the reservoir, whether functional or decommissioned. In conclusion, patients with retained IPP reservoirs are at potential risk for complications. Prosthesis erosion may appear in the differential diagnosis when patients with a history of IPP placement present with hematuria or LUTS. Long-term investigation is needed to identify patients at high risk of complications and to elucidate proper monitoring and best surgical practices to manage these complications.