title: Robotic radical prostatectomy in patients with preexisting inflatable penile prosthesis (IPP).
abstract: OBJECTIVE
  We present our initial experience with performing robotic-assisted prostatectomies in men with a 3-piece inflatable penile prosthesis with a pelvic reservoir.
  
  
  METHODS
  Four patients underwent transperitoneal robotic-assisted radical prostatectomies with a penile prosthetic implant in place. The reservoir was left inflated for easy identification. A flaccid reservoir may be more difficult to identify, and be prone to damage. The reservoir was left attached to the abdominal wall. Dissection was performed outside the fibrous capsule of the reservoir. The tissue around the capsule of the reservoir peeled off without difficulty. Cutting current close to the capsule can be used if needed as per American Medical System with no limit to voltage. The penile prosthesis is then inflated to empty the reservoir creating more prevesical space and preventing the reservoir from obscuring visualization. The remaining portion of the procedure is completed using our standard technique. After completing the urethrovesical anastomosis using the 16 French Foley, the prosthesis is cycled under direct vision and the penile prosthesis is deflated (reservoir full). The prosthesis is not used for 6 weeks to prevent stretching of the urethrovesical anastomosis.
  
  
  RESULTS
  All patients (n = 4) had no reported complications and all prostheses are functioning properly. The margin status was negative postoperatively.
  
  
  CONCLUSIONS
  Robotic prostatectomy is technically feasible in patients with inflatable penile prostheses by surgeons experienced in robotic surgery. However, the presence of an indwelling penile prosthesis does increase the complexity of surgery.
authors.affiliation: Department of Urology, School of Medicine, SUNY-Stony Brook Health Sciences Center, Stony Brook, New York 11794-8093, USA.
authors.forename: Jamil
authors.initials: J
authors.lastname: Rehman
authors.forename: Khurshid
authors.initials: K
authors.lastname: Guru
authors.forename: Bilal
authors.initials: B
authors.lastname: Chughtai
authors.forename: Ridwan
authors.initials: R
authors.lastname: Shabsigh
authors.forename: David
authors.initials: D
authors.lastname: Samadi
mesh_terms: D015897:Comorbidity; D003925:Diabetic Angiopathies / Q000453:epidemiology; D005240:Feasibility Studies; D006801:Humans; D010535:Laparoscopy; D008297:Male; D015917:Penile Prosthesis; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000453:epidemiology / Q000601:surgery; D012371:Robotics