Açık radikal retropubik prostatektomi sonrası inflatable penil protez rezervuarı, penoskrotal transvers insizyon ile Retzius alanına güvenle yerleştirilebilir
AMAÇ: Şişirilebilir üç parçalı IPP (3pIPP) rezervuarının rutin uygulamada yerleştirildiği bölge transversalis fasyasının altındaki Retzius alanıdır. Geçirilmiş majör pelvik cerrahiden sonra fibrozis gelişmesi olasılığı, Retzius boşluğuna penil protez rezervuarının yerleştirilmesini zorlaştırabilir. Penoskrotal transvers insizyon ile penil protez rezervuarının Retzius boşluğuna yerleştirilmesi ile ilgili olası komplikasyonları ve güvenlik kaygılarını ele almak amacıyla deneyimlerimizi gözden geçirdik. GEREÇ ve YÖNTEMLER: 2010–2017 yılları arasında transvers skrotal kesi ile 3pIPP implantasyonu yapılan 122 hastanın 39’unda lokalize prostat kanseri (PKa) nedeniyle açık retropubik radikal prostatektomi öyküsü mevcuttu (ARRP grubu). ARRP grubundaki hastaların 7’sine AMS LGX, 18’ine AMS 700 CX ve 14’üne Coloplast TITAN protez, radikal prostatektomi ve pelvik cerrahi öyküsü olmayan Non-ARRP grubu olarak belirlenen 83 olgunun 6’sına AMS LGX, 19’una AMS 700 CX ve 58’ine Coloplast TITAN protez yerleştirildi. Yerel etik kurul onayı alındıktan sonra grupların demografik özellikleri intraoperatif bulguları, postoperatif izlem verileri karşılaştırıldı. BULGULAR: ARRP ve Non-ARRP grubunun yaş ortalamaları sırasıyla 62,2±6,5 yıl ve 58,6±9,5 yıl idi (p=0,06). Sırasıyla ARRP ve Non-ARRP gruplarında ortalama cerrahi süreleri 57,2±11,3 ve 56,7±5,3 dakika (p=0,32); ortalama izleme süreleri ise 58,7±36,9 ve 50,1±27,5 ay idi (p=0,33). Toplam 58 aylık ortalama takip süresince ARRP grubunda birer olguda mekanik bozukluk (%2,6) ve protez enfeksiyonu (%2,6) gelişti. Non-ARRP grubunda ortalama 56 aylık takiplerde bir olguda inguinal herni gelişimine bağlı rezervuar dislokasyonu (%2,6); 3 olguda mekanik bozukluk (%3,6) ve bir olguda ise protez enfeksiyonu (%1,2) gözlendi. İPP implantasyonundan memnuniyet oranları ARRP ve Non-ARRP gruplarında sırasıyla 86,8±11,3 ve 85,8±12,2 idi (p=0,91). SONUÇ: Açık radikal prostatektomi öyküsü olan hastalarda, penoskrotal insizyonla üç parçalı penil protez ve rezervuarı retropubik Retzius boşluğuna düşük komplikasyon oranlarıyla ve yüksek tedavi memnuniyet oranları ile güvenle yerleştirilebilir. Nadiren gerekse de ektopik rezervuar yerleştirilmesi alternatif bir prosedür olarak akılda tutulmalı ve cerrahi sırasında bu aparat yedek olarak bulundurulmalıdır
The inflatable penile prosthesis reservoir can be safely placed in the space of retzius after open radical retropubic prostatectomy through a penoscrotal transverse incision
OBJECTIVE: The traditional placement area of three-pieces inflatable penile prosthesis (3pIPP) reservoir is the space of Retzius (SOR) below the transversalis fascia. Likelihood of developing of fibrosis after previous pelvic surgery may be a challenging factor that can make difficult to place reservoir in the SOR. We reviewed our experience to address potential complications and safety concerns regarding the placement of the penile prosthesis reservoir in the SOR using transverse scrotal incision. MATERIAL and METHODS: Of the 122 consecutive patients underwent 3pIPP placement from 2010 to 2017, 39 had a history of open radical retropubic prostatectomy (ORRP) for localized prostate cancer (PCa) (ORRP group). Of these patients, 7 were placed MS-LGX, 18 were placed AMS-700 CX, and 14 were placed Coloplast Titan device using penoscrotal incision. Eighty-three patients had no history of ORRP (Non-ORRP group). Six patients were placed MSLGX, 19 were placed AMS-700 CX, and 58 were placed Coloplast Titan device using penoscrotal incision. The groups were compared in terms of demographic characteristics, intraoperative findings, and postoperative follow-up data. RESULTS: The mean ages of the ORRP and Non-ORRP groups were 62.2±6.5 and 58.6±9.5 (p=0.06); the mean surgery times were 57.2±11.3 and 56.7±5.3 min (p=0.32); the mean follow-up periods were 58.7±36.9 and 50.1±27.5 months (p=0.33), respectively. Mechanical failure in one patient (2.6%) and prosthesis infection in one patient (2.6%) was observed in the ORRP group. In the Non-ORRP group, reservoir dislocation due to inguinal hernia in a patient (2.6%), mechanical failure in three patients (3.6%), and prosthesis infection in a patient (1.2%) was observed. The mean postoperative treatment satisfaction rates (EDITS) were 86.8±11.3 and 85.8±12.2 in ORRP and Non-ORRP groups, respectively (p=0.91). CONCLUSION: With low complication rates, 3pIPP with its reservoir can safely be placed in patients with a history of open radical prostatectomy using penoscrotal incision. Rarely, ectopic reservoir placement is required, and this apparatus should be available at the time of surgery.
___
- Mirza M, Griebling TL, Kazer MW. Erectile Dysfunction and urinary incontinence after prostate cancer treatment. Semin Oncol Nurs 2011;27:278–89. [CrossRef]
- Barocas DA, Alvarez J, Resnick MJ, Koyama T, Hoffman KE, Tyson MD, et al. Association Between Radiation Therapy, Surgery, or Observation for Localized Prostate Cancer and Patient-Reported Outcomes After 3 Years. JAMA 2017;317:1126–40. [CrossRef]
- Stolzenburg JU, Graefen M, Kriegel C, Michl U, Morales AM, Pommerville PJ, et al. Effect of surgical approach on erectile function recovery following bilateral nerve-sparing radical prostatectomy: an evaluation utilising data from a randomised, double-blind, double-dummy multicentre trial of tadalafil vs placebo. BJU Int 2015;116:241–51. [CrossRef]
- Kyrdalen AE, Dahl AA, Hernes E, Småstuen MC, Fosså SD. A national study of adverse effects and global quality of life among candidates for curative treatment for prostate cancer. BJU Int 2013;111:221–32. [CrossRef]
- Castiglione F, Ralph DJ, Muneer A. Surgical Techniques for Managing Post-prostatectomy Erectile Dysfunction. Curr Urol Rep 2017;18:90. [CrossRef]
- Salonia A, Burnett AL, Graefen M, Hatzimouratidis K, Montorsi F, Mulhall JP, Stief C. Prevention and management of postprostatectomy sexual dysfunctions. Part 1: choosing the right patient at the right time for the right surgery. Eur Urol 2012;62:261–72. [CrossRef]
- Ciftci H, Verit A, Savas M. Late complications of spontaneous urethral erosion of a malleable penile prosthesis in a young patient. Singapore Med J 2012;53:e120–1.
- Lane BR, Abouassaly R, Angermeier KW, Montague DK. ThreePiece inflatable penile prostheses can be safely implanted after radical prostatectomy through a transverse scrotal incision. Urology 2007;70:539–42. [CrossRef]
- Lledó-García E, Jara-Rascón J, Moncada Iribarren I, PiñeroSánchez J, Aragón-Chamizo 1, Hernández-Fernández C. Penile Prosthesis First and Replacement Surgeries: Analysis of Patient and Partner Satisfaction. J Sex Med 2015;12:1646–53. [CrossRef]
- Dadhich P, Hockenberry M, Kirby EW, Lipshultz L. Penile prosthesis in the management of erectile dysfunction following cancer therapy. Transl Androl Urol 2017;6(Suppl 5): S883–9. [CrossRef]
- Bratu O, Oprea I, Marcu D, Spinu D, Niculae A, Geavlete B, Mischianu D. Erectile dysfunction post-radical prostatectomy - a challenge for both patient and physician. J Med Life 2017;10:13–8.
- Wilson SK, Mulcahy JJ. Penile implants. In: Mulcahy JJ, editor. Male Sexual Function: A Guide to Clinical Management, 2nd ed. New Jersey: Humana Press, Inc.; 2006. pp.331–79.
- Montague DK. Penile prosthesis implantation in the era of medical treatment for erectile dysfunction. Urol Clin North Am 2011;38:217–25. [CrossRef]
- Eid JF. Surgery for erectile dysfunction. In: Wein AJ, Kavoussi LR, Partin AW, Peters CA, editors. Campbell-Walsh Urology, 11th edition. New York: Elsevier; 2016. pp.709–21.
- Turunç T, Deveci S, Güvel S, Peşkircioğlu L. Uluslararası cinsel işlev indeksinin 5 soruluk versiyonunun (IIEF-5) Türkçe geçerlilik çalışmasının değerlendirilmesi. Türk Üroloji Dergisi 2007;33:45–9
- Erdemir F, Bolat MS, Akdeniz E. Penil protezle seks. Androl Bul 2015;17-62:183–6.
- Karpman E, Brant WO, Kansas B, Bella AJ, Jones LA, Eisenhart E, Henry G. Reservoir alternate surgical implantation technique: preliminary outcomes of initial PROPPER study of low profile or spherical reservoir implantation in submuscular location or traditional prevesical space. J Urol 2015;193:239–44. [CrossRef]
- Henry GD, Karpman E, Brant W, Christine B, Kansas BT, Khera M, et al. The Who, How and What of Real-World Penile Implantation in 2015: The PROPPER Registry Baseline Data. J Urol 2016;195:427–33. [CrossRef]
- Lane BR, Abouassaly R, Angermeier KW, Montague DK. Threepiece inflatable penile prostheses can be safely implanted after radical prostatectomy through a transverse scrotal incision. Urology 2007;70:539–42. [CrossRef]
- Hakky T, Lentz A, Sadeghi-Nejad H, Khera M. The Evolution of the Inflatable Penile Prosthesis Reservoir and Surgical Placement. J Sex Med 2015;12 Suppl 7:464–7. [CrossRef]
- Perito P, Wilson S. The History of Nontraditional or Ectopic Placement of Reservoirs in Prosthetic Urology. Sex Med Rev 2016;4:190–3. [CrossRef]
- Levine LA, Hoeh MP. Review of penile prosthetic reservoir: complications and presentation of a modified reservoir placement technique. J Sex Med 2012;9:2759–69. [CrossRef]
- Capoccia EM, Phelps JN, Levine LA. Modified Inflatable Penile Prosthesis Reservoir Placement Into Space of Retzius: Comparing Outcomes in Men With or Without Prior Pelvic Surgery. J Sex Med 2017;14:968–73. [CrossRef]
- Levine LA, Becher E, Bella A, Brant W, Kohler T, MartinezSalamanca JI, et al. Penile Prosthesis Surgery: Current Recommendations From the International Consultation on Sexual Medicine. J Sex Med 2016;13:489–518. [CrossRef]
- Goldstein I, Newman L, Baum N, Brooks M, Chaikin L, Goldberg K, et al. Safety and efficacy outcome of mentor alpha-1 inflatable penile prosthesis implantation for impotence treatment. J Urol 1997;157:833–9
- ISSN: 2587-2524
- Yayın Aralığı: Yılda 4 Sayı
- Başlangıç: 1999
- Yayıncı: Turgay Arık
Sayıdaki Diğer Makaleler
HACI İBRAHİM ÇİMEN, Hacı Can DİREK, FİKRET HALİS, OSMAN KÖSE, AHMET GÖKÇE, HASAN SALİH SAĞLAM
Mustafa Suat BOLAT, Mehmet ÖZEN, Önder ÇINAR, Recep BÜYÜKALPELLİ, RAMAZAN AŞCI
KAAN SÖNMEZ, RAMAZAN KARABULUT, ZAFER TÜRKYILMAZ, Abdullah Can BAŞAKLAR
Fosfodiesteraz Tip-5 inhibitörlerinin semen parametrelerine etkisi
Rekürren varikosel tanı ve tedavisi
İnfertil bireylerde stres ve stresle başa çıkma yaklaşımları