title: 'A reservoir within a reservoir' - An unusual complication associated with a defunctioned inflatable penile prosthesis reservoir.
abstract: BACKGROUND
  Inflatable penile prostheses (IPP) have been a successful method of treating men with erectile dysfunction since the early 1970s. IPP are comprised of two intracorporal cylinders, a scrotal pump and a fluid reservoir.
  
  
  METHODS
  We present a case of a retained reservoir in a sixty eight year old gentlemen presenting with a cystic abdominal mass and bothersome LUTS, 15 years after the removal of the penile components of a three-piece penile prosthesis. Percutaneous drainage of the cyst was performed, with four litres of purulent fluid evacuated. A midline laparotomy was required to remove the reservoir and drain the collection completely.
  
  
  CONCLUSIONS
  Inflammatory reaction and subsequent erosion of an IPP reservoir is an infrequent but severe complication of IPP insertion, replacement or infection. Infection remains the primary indication for penile prosthesis removal and in this setting removal of the reservoir is routine. A thorough literature search has identified that in the non-infective setting, the routine removal of the original reservoir is not standard practice during three-component IPP replacement. In patients with a history of IPP presenting with new LUTS, reservoir erosion should be considered in the differential diagnosis and investigation with cystoscopy and computed tomography included early in the investigatory armament of the urologist.
  
  
  CONCLUSIONS
  It is our belief that a defunctionalized reservoir serves no purpose; rather it can only cause trouble in the future. Consequently, at our institution we do not leave defunctionalized reservoirs in situ.
authors.affiliation: Department of Urology, Royal Sussex County Hospital, Eastern Road, Brighton BN2 5BE, United Kingdom. Electronic address: hamid.abboudi@doctors.org.uk.
authors.forename: Hamid
authors.initials: H
authors.lastname: Abboudi
authors.affiliation: Department of Urology, Royal Sussex County Hospital, Eastern Road, Brighton BN2 5BE, United Kingdom. Electronic address: marcobolg@hotmail.com.
authors.forename: Marco
authors.initials: M
authors.lastname: Bolgeri
authors.affiliation: Department of Urology, Royal Sussex County Hospital, Eastern Road, Brighton BN2 5BE, United Kingdom. Electronic address: drrajnair@hotmail.com.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Nair
authors.affiliation: Department of Urology, Royal Sussex County Hospital, Eastern Road, Brighton BN2 5BE, United Kingdom. Electronic address: andrewchetwood@doctors.org.uk.
authors.forename: Andrew
authors.initials: A
authors.lastname: Chetwood
authors.affiliation: Department of Urology, Royal Sussex County Hospital, Eastern Road, Brighton BN2 5BE, United Kingdom. Electronic address: andy.symes@bsuh.nhs.uk.
authors.forename: Andrew
authors.initials: A
authors.lastname: Symes
authors.affiliation: Department of Urology, Royal Sussex County Hospital, Eastern Road, Brighton BN2 5BE, United Kingdom. Electronic address: philip.thomas@bsuh.nhs.uk.
authors.forename: Philip
authors.initials: P
authors.lastname: Thomas
keywords: Erectile dysfunction; Inflatable penile prosthesis; Lower urinary tract symptoms; Prosthesis reservoir