(331) Management of Reservoir Tubing Breakage in an Inflatable Penile Implant

Abstract Introduction Inflatable penile prosthesis (IPP) malfunction is a known complication that may occur even in relatively new devices. While pump and cylinder defects are common, reservoir or tubing failures, especially distal to the lockout valve, are exceedingly rare. Objective In this surgical video, we demonstrate a step-by-step revision of an IPP for device malfunction due to a rare site of tubing failure just distal to the reservoir lockout valve. Methods A 62-year-old male with a Coloplast Titan Touch IPP implanted one year prior presented with signs of mechanical failure. Preoperative ultrasound showed an empty reservoir, suggesting a tubing defect. A standard penoscrotal approach was used for exploration. Upon inspection, no defects were found in the pump or visible tubing. Both cylinders were removed and found to be intact. Although the device was relatively new, the surgical team elected to perform a complete system revision, including reservoir replacement, to eliminate any potential source of leakage. Results A separate counter-incision over the reservoir allowed for direct access and revealed a rare tubing rupture distal to the lockout valve. The old reservoir space was closed and a new one created. A new IPP system was implanted, with all components connected and wounds closed in the standard fashion. Conclusions This case underscores the importance of considering complete system revision in cases of suspected leakage, even in relatively new implants. The reservoir and its tubing may be the source of failure. Disclosure No