Our experience suggests that the IVS sling system, which uses a multi-filament polypropylene suburethral mesh, incurs an unacceptably high rate of defective vaginal wound healing and mesh extrusion.
Infection is a devastating complication of penile prosthesis surgery that occurs in approximately 2-5% of all primary inflatable penile primary implants in most series. Prevention of hematoma and swelling with closed-suction drains has been shown not to increase infection rate and yield an earlier recovery time. Despite the intuitive advantages of short-term closed-suction drainage in reducing the incidence of postoperative scrotal swelling and associated adverse effects, many urologists are reluctant to drain the scrotum because of a theoretical risk of introducing an infection. In conclusion, this study was undertaken to evaluate the incidence of infection in threepiece penile prosthesis surgery with scrotal closed-suction drainage. A retrospective review of 425 consecutive primary three-piece penile prosthesis implantations was performed at three institutions in New Jersey, Ohio, and Arkansas from 1998 to 2002. Following the prosthesis insertion, 10 French Round Blake (Johnson & Johnson) or, in a few cases, 10 French Jackson Pratt, closed-suction drains were placed in each patient for less than 24 h. All subjects received standard perioperative antibiotic coverage. Average age at implant was 62 y (range 24-92 y). Operative time (incision to skin closure) was less than 60 min in the vast majority of cases. There were a total of 14 (3.3%) infections and three hematomas (0.7%) during an average 18-month follow-up period. In conclusion, this investigation revealed that closed-suction drainage of the scrotum for approximately 12-24 h following three-piece inflatable penile prosthesis surgery does not result in increased infection rate and is associated with a very low incidence of postoperative hematoma formation, swelling, and ecchymosis.
Introduction
We describe a 51-year-old man with a history of radiation therapy and large bowel diversion for rectal cancer who underwent an uneventful penile implant surgery for erectile dysfunction that was refractory to conservative therapy. The patient presented with acute left lower extremity swelling and pain a few days after surgery. Workup revealed compression of the pelvic veins by the prosthesis reservoir.
Aim
To highlight an avoidable, adverse event related to penile prosthesis reservoirs.
Methods
Retrospective review of a clinical case.
Results
The patient underwent repositioning of the reservoir followed by venous thrombectomy and Greenfield filter placement.
Conclusion
To the best of our knowledge, this is the first report of an early diagnosis and successful thrombectomy of the external iliac and common femoral vein thrombosis secondary to reservoir compression. Awareness of this possible adverse event and the management strategy are helpful to surgeons who perform penile prosthesis surgery.
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