Bladder migration of penile prosthesis reservoir. A rare and challenging complication occurring in a patient previously treated for two other prior prosthesis-related complications

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One of the most popular tools for treating drug-resistant erectile dysfunction is a three-component inflatable prosthesis. Despite being a well-established surgical treatment, serious complications can occur, although uncommon. One of such complications is the spontaneous migration of one or more prosthesis components into the surrounding tissues, which is rarely described in the literature.1 Six years prior, a three-component penile prosthesis had been implanted in a 66-year-old patient with no significant comorbidities. The etiology of erectile dysfunction was multifactorial in a patient with only mild arterial hypertension. Intracavernosal injections (ICI) or vacuum erection devices (VED) were not attempted, as the patient presented to our urologic unit strongly motivated to undergo prosthetic surgery. No intraoperative or perioperative complications were observed. The prosthesis implanted was an AMS 700 LGX and the reservoir was placed in the right paravesical space through a second right inguinal incision. Four years after the implantation of the device, an aneurysmal dilation of one of its two cylinders occurred. A Magnetic Resonance Imaging (MRI) scan was performed, demonstrating only the aneurysmal dilation with no suspicion of reservoir migration, therefore he underwent the replacement of both cylinders and the pump, avoiding the substitution of the reservoir (Figure S1).

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