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Hello,

I've heard about something called "drain and retain" in which the old reservoir is emptied and the connective tubing from the pump cut off as high as possible. "D&R" sounds like a more straightforward surgery with one less incision, but it does leave behind "junk". Curious if anyone else has heard of this and have any thoughts.

Many thanks for considering my request.

Raider82 wrote:Hello,

I've heard about something called "drain and retain" in which the old reservoir is emptied and the connective tubing from the pump cut off as high as possible. "D&R" sounds like a more straightforward surgery with one less incision, but it does leave behind "junk". Curious if anyone else has heard of this and have any thoughts.

Many thanks for considering my request.

This is part of why replacement surgery is difficult enough that many doctors that do implants will not do the replacement surgery. I did a lot of research before my surgery and my doctor had videos of removing the old reservoir and causing a major bleed. Seems there is a sizeable blood vessel that can be ruptured during the removal of the old reservoir and it is at a location that makes it difficult to locate and repair. Many doctors that do a replacement surgery will thin leave the first reservoir in place and put the new reservoir on the other side. This is for penoscrotal approach where there is no additional incision needed. Some infapubic approach surgeries use one incision also. Just depends on the doctor. If this is a concern for you then it would be a question to ask the doctor(s) you interview for this surgery.

newbie443 wrote:

Raider82 wrote:Hello,

I've heard about something called "drain and retain" in which the old reservoir is emptied and the connective tubing from the pump cut off as high as possible. "D&R" sounds like a more straightforward surgery with one less incision, but it does leave behind "junk". Curious if anyone else has heard of this and have any thoughts.

Many thanks for considering my request.

This is part of why replacement surgery is difficult enough that many doctors that do implants will not do the replacement surgery. I did a lot of research before my surgery and my doctor had videos of removing the old reservoir and causing a major bleed. Seems there is a sizeable blood vessel that can be ruptured during the removal of the old reservoir and it is at a location that makes it difficult to locate and repair. Many doctors that do a replacement surgery will thin leave the first reservoir in place and put the new reservoir on the other side. This is for penoscrotal approach where there is no additional incision needed. Some infapubic approach surgeries use one incision also. Just depends on the doctor. If this is a concern for you then it would be a question to ask the doctor(s) you interview for this surgery.

What happens when the patient needs a 3rd revisor?

Then you need to find a doctor that removes and replaces the reservoir.

Thank you, newbie443. I appreciate your input.

My IPP cylinders and pump were placed using a penoscrotal incision, which worked well. However, the reservoir was inserted via an abdominal incision just above my pubic mound, leaving it close to the bladder, which thankfully works fine. Because of its age (18 years) and an old scar tissue/capsule, I'm concerned about the risks of trying to "dig" it out. I've had some consultations and gotten mixed opinions (sure, we can get it; no, leave it and we'll find a new home).

Thanks again.

My revision was done via penoscrotal and my failed implant from 24 years ago was placed infrapubic.
My surgeon left the old reservoir explaining that it will do no harm where it is...and removing it would be challenging and not worth the risk of injury or damage to healthy tissue. I agree.