Direct vision reservoir placement in the space of Retzius via a secondary lateral suprapubic incision in patients with a scarred pelvis: a single-center experience.

Ectopic or high submuscular insertion of the inflatable penile prosthesis reservoir minimizes complications associated with placing a reservoir in a retroperitoneal pelvic space scarred from previous surgery. A separate secondary lateral suprapubic incision allows direct visualization during reservoir placement and provides controlled access to the intended anatomical plane. This single-center retrospective study evaluated the safety and feasibility of 3-piece inflatable penile prosthesis reservoir placement in the Space of Retzius (SOR) via a secondary lateral suprapubic incision in 90 patients with previous pelvic abdominal surgery. The reservoir was placed under direct vision within the SOR plane through a secondary lateral suprapubic incision, avoiding high submuscular or abdominal-wall ectopic reservoir placement. The median follow-up period was 76 months (IQR: 60-83.5). The most common prior pelvic surgeries were open radical prostatectomy (71.1%), cysto-prostatectomy (21.1%), and bilateral inguinal hernia repair (7.8%). Postoperative complications occurred in 3 patients (3.3%) (two infections and one mechanical failure). Direct-vision reservoir placement in the SOR using a secondary lateral suprapubic incision appears safe and feasible even in patients with previous pelvic surgery.