Alternative Reservoir and Balloon Placement in Complex Patients Undergoing Urologic Prostheses.

PURPOSE OF REVIEW: To evaluate contemporary rationale and techniques for ectopic reservoir/balloon placement in complex urologic prosthetics patients.

RECENT FINDINGS: Recent studies have demonstrated that ectopic reservoir placement is safe and durable when compared to traditional space of Retzius placement. Complex patients exist on a spectrum from those with a previously violated retropubic space, to those with bilaterally obscured external inguinal rings and/or multiple prior prosthetic reservoirs. Ectopic placement has become more commonplace and accepted as a viable alternative strategy over the past 7 years. Concerns relating to reservoir palpability and long-term outcomes have been allayed. The risk of deep pelvic complications appears to be negligible after both placement or removal of ectopic reservoirs when performed by experienced implanters even in the most complex patient. Ectopic placement of prosthetic balloons and reservoirs offers unique advantages and has become commonplace in contemporary prosthetic urology practice.