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Urinary Imaging

E2762. Rising to the Occasion: Radiologists’ Role in Evaluating Inflatable Penile Prostheses Using CT

Hole S1,  Haug J2,  Hudak S3,  Schwope R3,  Lisanti C.2 1. San Antonio Uniformed Services Health Education Consortium, San Antonio, TX; 2. Brooke Army Medical Center, Fort Sam Houston, TX; 3. San Antonio Military Medical Center, Fort Sam Houston, TX

Address correspondence to J. Haug (james.c.haug2.mil@mail.mil)

Background Information: The purpose of this exhibit is to describe the various components of inflatable penile prosthetic devices, its normal appearance on CT, and demonstrate various common postsurgical complications, which will help radiologists detect subtle complications.

Educational Goals/Teaching Points: Inflatable penile prosthetic (IPP) devices are becoming more common in patients with erectile dysfunction, who have failed conservative therapy or treatment. We describe the various components and demonstrate normal CT appearance and demonstrate various common postsurgical complications regarding IPP devices using CT.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques: We present normal penile anatomy and types of inflatable penile prosthetic devices, along with the benefits and drawbacks of various types, a review of components and hardware of IPP devices, and key surgical steps and procedure. We discuss use of CT and indications for CT in evaluating IPP devices including discussion of CT protocol for evaluating IPP device, and approach to CT evaluation of IPP device. Participants will learn post-surgical complications including acute infection, abscess, hemorrhage and hematoma, migration or erosion of any component, and mechanical malfunctions (cylinder, pump, reservoir leak or rupture; cylinder aneurysmal dilatation; and cylinder buckling or kinking).

Conclusion: CT offers unique benefits in evaluating the integrity of inflatable prosthetic devices as well as commonly associated postsurgical complications. Often, IPPs are imaged incidentally and may be inadequately evaluated due to unfamiliarity by the radiologist. Recognizing the imaging features unique to these devices on CT will enable the radiologist to promptly and accurately diagnose these complications to assist urologists in managing patient care.