Abstract: PD25-09
Sources of Funding: None

Introduction

The AMS Conceal inflatable penile prosthesis (IPP) reservoir was introduced to the US market in February 2011. Unlike prior spherical models, the Conceal reservoir is known for its low profile and flat shape, which has rendered the Conceal the most common choice for ectopic placement. Consistent with its innovative shape, the reservoir allows for flexibility in filling volume, which ranges from 60 mL to 100 mL. This study seeks to identify any emerging mechanical failures and complications related to ectopic placement of the Conceal reservoir.

Methods

Our single surgeon database of IPP implantation from February 2011 to December 2015 was reviewed and all reservoir-related mechanical failures and complications were identified. Only AMS inflatable penile prostheses with Conceal reservoirs were included in this study. Coloplast penile prostheses and malleable implants were excluded. The location of the reservoir, as well as the volume of saline used to fill the reservoir, were part of the data analyzed.

Results

A total of 210 AMS IPP with Conceal reservoirs were included in this study. From this data set, there were four cases (1.9%) with reservoir-related mechanical failure or complication requiring revision surgeries. Of those four, two cases (0.95%) were mechanical failures resulting from the reservoir leaking. In both cases, the cause of leak was identified as an intrinsic point of weakness at the apex of the reservoir caused by inward folding of an unfilled segment. The inward folding of the reservoir was observed at volumes of 60 to 80 mL. In the remaining two cases (0.95%), the reservoir complication observed was refractory abdominal muscle pain related to ectopic location and intra-fascial placement. In both cases, revision surgery with reservoir repositioning resolved the pain.

Conclusions

While ectopic placement of the Conceal reservoir is mechanically reliable, it must be filled in excess of 80 mL to prevent inward reservoir folding and resultant reservoir leakage. Additionally, with surgical consent, it is prudent for the patient to be counseled on the possibility of abdominal muscle pain when the reservoir is placed ectopically, though they should be informed that such pain is a rare side effect.

Funding

None