P-01-024 Treatment of Prostate Cancer and Sexual Rehabilitation when a Nerve-sparing Procedure is not Feasible: Placement of the Reservoir for a Three-Component Penile Implant During Robotic Extra-Aponeurotic Radical Prostatectomy

Abstract

In high - risk prostate cancer patients or in preoperative impotent ones, a nerve sparing procedure is not feasible, and potency can be restored by a penile prosthetic implant (PPI). After a transperitoneal robotic radical prostatectomy (RALP), the delayed intra - abdominal placement of the reservoir can be unsafe and often requires a second incision and/or the placement in “ectopic position”. We propose the synchronous reservoir placement during RALP in motivated patients. Complete preoperative and postoperative sexual function assessment was performed. Preoperative prophylaxis with piperacilline/tazobactam and amikacin was administered before extra - aponeurotic RALP. An empty AMS Inhibizone reservoir, with a 15 cm tube closed by the cap, was introduced in the abdomen through a lateral trocar. A 1,5 cm incision at the peno – scrotal angle was performed and the tip of a Kelly forceps was introduced into the abdominal cavity through the distal inguinal tract in order to grab the distal end of the tube. The tube was then drawn out and fixed in the subdartoic space. The procedure was performed in 5 patients. The PPI was implanted 1,5 to 2,5 months later by penoscrotal approach.