Penile prosthesis reservoir, intraperitoneal vs extraperitoneal placement, experience of a single-center study

Aim of the study: The penile prosthesis implant is the gold standard for the treatment of Erectile Deficiency (ED) resistant to medical therapy. Different implantation and placement techniques of resevoir have been described, the choice of which to use is based on the clinical characteristics of the patient and on the experience of the surgeon. Materials and methods: Since June 2012, 52 patients underwent implantation of AMS-LGX InhibiZone prosthesis, 13 with retropubic reservoir (RP) and 39 intraperitoneal resevoir (IP). Before the operation, each patient underwent to fisical examination. The preoperative characteristics of the two groups: average age of 65 years in both groups; for 69% of patients in the RP group and in 62% of the IP group the cause of ED is radical prostatectomy, in other cases the cause is related to systemic disease. Follow-up included scheduled follow-up visits every 3 months, the first year, and then every 6 months. The satisfaction rate was assessed by specific questionnaire (QoL Sexuality with penile Prosthesis) during the monitoring visits, at least 12 months after surgery or by telephone. Results: The preoperative mean scores of IIEF, HADS and ECOG did not differ in the two groups. The results of the questionnaires were compared between the two groups as overall scores and also as a percentage of patients who reached the level of high satisfaction (70%) of the maximum value. The significant differences are in favor of the group with IP reservoir with regard to the appearance of the personal domain and as a total score of all the domains. Discussion: In our experience the intraperiotoneal reserervoir placememt is safe and offers advantages in functional and acceptance terms, as demonstrated by the results of the QoLSpP questionnaire.