Mp76-07 the Utilization of Pre-Operative Imaging in Post Traditional Radical Prostatectomy Patients Undergoing Inflatable Penile Prosthesis Placement

You have accessJournal of UrologySexual Function/Dysfunction: Surgical Therapy II (MP76)1 May 2024MP76-07 THE UTILIZATION OF PRE-OPERATIVE IMAGING IN POST TRADITIONAL RADICAL PROSTATECTOMY PATIENTS UNDERGOING INFLATABLE PENILE PROSTHESIS PLACEMENT Eva M. Mace, Ashley Foret, Timothy Carroll, Jacob Garrett, and Matthew Mutter Eva M. MaceEva M. Mace , Ashley ForetAshley Foret , Timothy CarrollTimothy Carroll , Jacob GarrettJacob Garrett , and Matthew MutterMatthew Mutter View All Author Informationhttps://doi.org/10.1097/01.JU.0001009484.98400.42.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Traditional robot assisted radical prostatectomy (RARP) disrupts the space of Retzius (SoR) and may result in small bowel injury with traditional SoR reservoir placement during 3-piece penile prosthesis placement. Given this, ectopic reservoir placement is a widely accepted practice in patients who have undergone prior non-Retzius sparing robotic-assisted radical prostatectomy, despite potential for easier herniation and palpability of the reservoir. Reservoir placement in the SoR is generally avoided in post RARP patients due to concern of bowel injury. Our aim is to evaluate the incidence of incidental small bowel found in the SoR after RARP utilizing post-surgical imaging. Secondarily, we aimed to evaluate the proximity of small bowel to the pubis in this population. METHODS: 434 men who underwent RARP in our department between 01/2012 and 09/2020 were eligible for inclusion. We identified 162 men with incidentally obtained cross-sectional imaging available after RARP. For men with multiple scans, the most recent was used. Of these, men whose imaging was within one month of surgery or who had complicating factors such as post-operative drains were excluded (n=42). The primary endpoint was identification of bowel posterior to the midline of the pubic symphysis. In cases without bowel found in the SoR, distance from the superior aspect of the pubis to the closest bowel loop was recorded. Measurements were taken in either the sagittal or axial dimensions. Patient demographic and surgical features were evaluated to determine if there was an association among patients with bowel found in the SoR. RESULTS: 120 men were eligible for inclusion. The mean time from RARP to imaging was 19.4 months. In total, 8/120 (6.6%) men had intra-abdominal contents within the SoR. For men without bowel in the SoR, the mean distance from bowel to the superior aspect of the pubis was 3.81 cm. The most common finding among majority of patients (7/8) with bowel found in SoR was a decompressed urinary bladder at the time of imaging. CONCLUSIONS: Based on our observations, penile prosthesis reservoir placement in the SoR can be safely performed, with respect to potential bowel injury in the majority of patients who have undergone prior non-Retzius sparing RARP. Cross sectional imaging may be obtained prior to implantation to evaluate for the presence of bowel within the SoR and guide reservoir placement. Further research evaluating the location of bowel pre- and post-RARP as well as whether this is static or changeable is ongoing. Source of Funding: N/A © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1245 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Eva M. Mace More articles by this author Ashley Foret More articles by this author Timothy Carroll More articles by this author Jacob Garrett More articles by this author Matthew Mutter More articles by this author Expand All Advertisement PDF downloadLoading ...