Presentation
History of penile prosthesis insertion for erectile dysfunction 15 months ago.
Patient Data
A three-piece inflatable penile prosthesis (IPP), having two inflatable cylinders placed in the corpora cavernosa, a pump placed in the scrotum and a reservoir placed behind the right rectus abdominis muscle in the perivesical extraperitoneal space anterolateral to the urinary bladder. All the components are interconnected by silicone tubing. The reservoir appears small in size and has an average volume of ~40 ml only. Urinary bladder is partially filled (~volume=120-135 ml). No free fluid/collection is noted in the pelvis.
Multiple diverticula are seen in the sigmoid colon as well as in the visualized distal descending colon; however, no inflammatory changes are seen in the surrounding mesentery. Surgical sutures are noted adjacent to the cecum which are likely related to the previous appendectomy. Small fat containing umbilical hernia and right inguinal hernia.
Reformatted VR images and selected axial images with annotations showing different components of the three-piece inflatable penile prosthesis. R=reservoir.
Case Discussion
History of diabetes mellitus, hypertension and dyslipidemia with erectile dysfunction. History of failure of low-intensity extracorporeal shock wave therapy (LI-ESWT) for erectile dysfunction. Patient refused intracavernosal injection (ICI) therapy for erectile dysfunction and underwent three-piece inflatable penile prosthesis insertion. The penile reservoir was inflated with ~110 ml of saline at the time of insertion. 15 months later, he presented with device malfunction and a CT pelvis was requested which showed partially deflated reservoir, likely due to leakage.
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