title: Reservoir herniation as a complication of three-piece penile prosthesis insertion.
abstract: OBJECTIVE
  To obtain data concerning the incidence and management of reservoir herniation in inflatable penile prosthesis surgery in a clinical investigation. Reservoir herniation after scrotal placement of inflatable penile prosthesis is an unusual complication, and a review of the published medical reports reveals only anecdotal reports and no definitive articles.
  
  
  METHODS
  A multi-item self-addressed questionnaire was mailed to the members of the Society for the Study of Impotence questioning the occurrence of reservoir migration from the prevesical space to the inguinal canal or scrotum. In addition, the database of one of us was reviewed to determine the incidence of reservoir migration in a large series of 1206 three-piece penile prostheses.
  
  
  RESULTS
  The response rate was 38%. A minority of respondents (28%) were familiar with the problem. Of those who had experienced this complication, the occurrence was very rare and usually appeared in the immediate postoperative period, often in association with vigorous coughing spells or vomiting. The responders also indicated that imperfect surgical technique might have been implicated in some cases. Management usually consisted of reservoir replacement or repositioning through an inguinal incision with repair of the defect. Alternatively, several surgeons used the existing scrotal incision if the patient presented in the immediate postoperative period. The incidence of reservoir herniation was 0.7%.
  
  
  CONCLUSIONS
  Reservoir herniation is a rare complication of inflatable penile prosthesis surgery that occurs almost exclusively in penoscrotally placed prostheses. Familiarity with various approaches to the management of this complication is clinically useful to urologists performing penile prosthesis surgery.
authors.affiliation: Section of Urology, Department of Surgery, University of Medicine and Dentistry New Jersey Medical School, Newark, New Jersey, USA.
authors.forename: H
authors.initials: H
authors.lastname: Sadeghi-Nejad
authors.forename: A
authors.initials: A
authors.lastname: Sharma
authors.forename: R J
authors.initials: RJ
authors.lastname: Irwin
authors.forename: S K
authors.initials: SK
authors.lastname: Wilson
authors.forename: J R
authors.initials: JR
authors.lastname: Delk
mesh_terms: D005548:Foreign-Body Migration / Q000209:etiology*; D019538:Health Care Surveys / Q000706:statistics & numerical data; D006547:Hernia / Q000209:etiology; D006801:Humans; D008297:Male; D015917:Penile Prosthesis / Q000009:adverse effects*; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012611:Scrotum; D011795:Surveys and Questionnaires