{"id":32971,"date":"2026-09-09T18:14:00","date_gmt":"2026-09-09T22:14:00","guid":{"rendered":"https:\/\/www.rigicon.com\/?post_type=glossary-term&p=32971"},"modified":"2026-10-07T01:28:59","modified_gmt":"2026-10-07T05:28:59","slug":"mau-posicionamento-do-reservatorio-ipp","status":"publish","type":"glossary-term","link":"https:\/\/www.rigicon.com\/pt-br\/glossary-term\/mau-posicionamento-do-reservatorio-ipp\/","title":{"rendered":"Mau Posicionamento do Reservat\u00f3rio (IPP)"},"content":{"rendered":"","protected":false},"excerpt":{"rendered":"","protected":false},"featured_media":0,"template":"","glossary-category":[117],"glossary-product":[104,105],"class_list":["post-32971","glossary-term","type-glossary-term","status-publish","hentry","glossary-category-prosthetic-implants","glossary-product-infla10-pulse-ipp-series","glossary-product-rigi10-malleable-penile-prosthesis"],"acf":{"gt-definition":"<p>O mau posicionamento do reservat\u00f3rio \u00e9 uma complica\u00e7\u00e3o da cirurgia de pr\u00f3tese peniana infl\u00e1vel (IPP) de tr\u00eas volumes na qual o reservat\u00f3rio de fluido se encontra, ou se desloca, em uma posi\u00e7\u00e3o n\u00e3o pretendida. Problemas agudos geralmente decorrem de perfura\u00e7\u00e3o direta no momento da coloca\u00e7\u00e3o do reservat\u00f3rio, enquanto complica\u00e7\u00f5es tardias est\u00e3o mais frequentemente relacionadas a migra\u00e7\u00e3o do reservat\u00f3rio ou da tubula\u00e7\u00e3o, eros\u00e3o, forma\u00e7\u00e3o de f\u00edstula, obstru\u00e7\u00e3o ou hernia\u00e7\u00e3o.<sup>1<\/sup> As complica\u00e7\u00f5es do reservat\u00f3rio relatadas incluem hernia\u00e7\u00e3o inguinal, eros\u00e3o para a bexiga ou o intestino, coloca\u00e7\u00e3o intraperitoneal com subsequente les\u00e3o do ureter ou do intestino, les\u00e3o vascular e autoinsufla\u00e7\u00e3o.<sup>2<\/sup> A migra\u00e7\u00e3o do reservat\u00f3rio pelo canal inguinal \u00e9 rara, com frequ\u00eancias relatadas de 0,09% a 1,2% ap\u00f3s a coloca\u00e7\u00e3o no espa\u00e7o de Retzius e de 1,4% ap\u00f3s outras coloca\u00e7\u00f5es do reservat\u00f3rio.<sup>3<\/sup> O mau posicionamento tamb\u00e9m pode estar presente desde o in\u00edcio: em um modelo cadav\u00e9rico de coloca\u00e7\u00e3o submuscular alta \u00e0s cegas, os reservat\u00f3rios acabaram em camadas anat\u00f4micas vari\u00e1veis, inclusive dentro da cavidade peritoneal ou imediatamente superficiais a ela, sem que o cirurgi\u00e3o percebesse.<sup>4<\/sup> As complica\u00e7\u00f5es do reservat\u00f3rio s\u00e3o incomuns, mas podem exigir cirurgia de revis\u00e3o.<sup>5<\/sup><\/p>","gt-synonyms":"Posicionamento submuscular alto do reservat\u00f3rio, Posicionamento submuscular do reservat\u00f3rio, Posicionamento alternativo do reservat\u00f3rio, Posicionamento n\u00e3o tradicional do reservat\u00f3rio, Posicionamento do reservat\u00f3rio na parede abdominal, Posicionamento ect\u00f3pico do reservat\u00f3rio de IPP","gt-citation":"[1] Michael S, Grice P, Oumeziane A, et al. Recognition to repair: Managing reservoir complications in inflatable penile prosthesis surgery. BJUI Compass. 2026;7(7):e70246. doi:10.1002\/bco2.70246. PMID: 42415952.\n\n[2] Levine LA, Hoeh MP. Review of penile prosthetic reservoir: complications and presentation of a modified reservoir placement technique. J Sex Med. 2012;9(11):2759-69. doi:10.1111\/j.1743-6109.2012.02807.x. PMID: 22672516.\n\n[3] Patel J, Zakkar B, Polchert M, Tannenbaum J, Dick B, Raheem O. Recent technological development of penile prosthesis: a literature review. Transl Androl Urol. 2024;13(1):165-184. doi:10.21037\/tau-22-741. PMID: 38404551.\n\n[4] Ziegelmann MJ, Viers BR, Lomas DJ, Westerman ME, Trost LW. Ectopic Penile Prosthesis Reservoir Placement: An Anatomic Cadaver Model of the High Submuscular Technique. J Sex Med. 2016;13(9):1425-1431. doi:10.1016\/j.jsxm.2016.06.012. PMID: 27475239.\n\n[5] Clavell-Hern\u00e1ndez J, Shah A, Wang R. Non-Infectious Reservoir-Related Complications During and After Penile Prosthesis Placement. Sex Med Rev. 2019;7(3):521-529. doi:10.1016\/j.sxmr.2018.12.005. PMID: 30786958.\n\n[6] Raikin J, Woodruff M, Meshekow G, Debski ND, Germaine P, Gor R. Urologic prosthetics: an imaging review of short- and long-term complications. Abdom Radiol (NY). 2025;50(1):290-304. doi:10.1007\/s00261-024-04491-6. PMID: 38985291.\n\n[7] O'Rourke TK Jr, Erbella A, Zhang Y, Wosnitzer MS. Prevention, identification, and management of post-operative penile implant complications of infection, hematoma, and device malfunction. Transl Androl Urol. 2017;6(Suppl 5):S832-S848. doi:10.21037\/tau.2017.06.07. PMID: 29238663.\n\n[8] Hamada A, Lai L, Staskin D, Alanee S. Spontaneous Erosion of a 15-Year-Old Retained Inflatable Penile Prosthesis Reservoir Into the Bladder: A Case Report and Literature Review. Cureus. 2026;18(4):e107422. doi:10.7759\/cureus.107422. PMID: 42181313.\n\n[9] Brison D, Ilbeigi P, Sadeghi-Nejad H. Reservoir repositioning and successful thrombectomy for deep venous thrombosis secondary to compression of pelvic veins by an inflatable penile prosthesis reservoir. J Sex Med. 2007;4(4 Pt 2):1185-7. doi:10.1111\/j.1743-6109.2006.00266.x. PMID: 17627728.\n\n[10] Ioannis M, Georgios L, Stavros T, Anastasios A, Koenraad VR. Update on penile prosthesis. Asian J Androl. 2026;28(1):23-30. doi:10.4103\/aja2024100. PMID: 40341570.\n\n[11] Lee WG, Satchi M, Skrodzka M, Papavasileiou G, Ralph D. A Rare Cause of Autoinflation after Penile Prosthesis Insertion: Case Series and Systematic Review. J Sex Med. 2022;19(5):879-886. doi:10.1016\/j.jsxm.2022.01.262. PMID: 35184996.\n\n[12] Al-Enezi A, Al-Khadhari S, Al-Shaiji TF. Three-piece Inflatable Penile Prosthesis: Surgical Techniques and Pitfalls. J Surg Tech Case Rep. 2011;3(2):76-83. doi:10.4103\/2006-8808.92798. PMID: 22413049.\n\n[13] Sedigh O, Soleimanzadeh F, Buffi N, et al. Penile implant reservoir placement methods: is there a gold standard? Asian J Androl. 2026;28(1):16-22. doi:10.4103\/aja202593. PMID: 41508316.\n\n[14] Kavoussi M, Cook GS, Nordeck SM, et al. Radiographic Assessment of Inflatable Penile Prosthesis Reservoir Location Variability in Contemporary Practice. J Sex Med. 2021;18(12):2039-2044. doi:10.1016\/j.jsxm.2021.09.015. PMID: 34753688.","gt-clinical-context":"<p>A hernia\u00e7\u00e3o ocorre quando o espa\u00e7o criado pelo anel inguinal \u00e9 grande o suficiente para que, com o aumento da press\u00e3o abdominal, o reservat\u00f3rio hernie total ou parcialmente pelo anel externo; geralmente n\u00e3o afeta o funcionamento do dispositivo, mas pode causar desconforto que justifique a corre\u00e7\u00e3o.<sup>6<\/sup> Pacientes com reservat\u00f3rio herniado apresentaram dor aguda ou massa escrotal palp\u00e1vel, e hemat\u00faria, sintomas miccionais ou disfun\u00e7\u00e3o intestinal podem indicar coloca\u00e7\u00e3o intraperitoneal e les\u00e3o visceral.<sup>7<\/sup> Um reservat\u00f3rio retido e desativado sofreu eros\u00e3o para a bexiga 15 anos ap\u00f3s a coloca\u00e7\u00e3o, manifestando-se com hemat\u00faria macrosc\u00f3pica, infec\u00e7\u00f5es recorrentes do trato urin\u00e1rio e piora dos sintomas do trato urin\u00e1rio inferior.<sup>8<\/sup> Um reservat\u00f3rio que comprime as veias p\u00e9lvicas pode causar edema da perna e trombose venosa profunda poucos dias ap\u00f3s a cirurgia.<sup>9<\/sup> A autoinsufla\u00e7\u00e3o, a transfer\u00eancia indesejada de fluido do reservat\u00f3rio para os cilindros, ocorre frequentemente no in\u00edcio do p\u00f3s-operat\u00f3rio com o aumento da press\u00e3o abdominal e acredita-se que resulte da c\u00e1psula tecidual que geralmente se forma ao redor do reservat\u00f3rio em at\u00e9 3 meses.<sup>10<\/sup> A palpabilidade requer interpreta\u00e7\u00e3o, pois uma palpabilidade sutil de um reservat\u00f3rio submuscular pode ser normal, especialmente em uma parede abdominal fina.<sup>6<\/sup><\/p>\n<p>A tomografia computadorizada \u00e9 amplamente dispon\u00edvel e r\u00e1pida, sendo a modalidade diagn\u00f3stica de escolha quando surgem complica\u00e7\u00f5es da pr\u00f3tese; a resson\u00e2ncia magn\u00e9tica fornece detalhes anat\u00f4micos, mas \u00e9 usada com menos facilidade.<sup>6<\/sup> Os exames de imagem mostram onde um reservat\u00f3rio migrado se encontra em rela\u00e7\u00e3o ao anel externo e, assim, orientam a abordagem cir\u00fargica.<sup>6<\/sup> Aconselha-se um limiar baixo para a realiza\u00e7\u00e3o de TC de abdome e pelve com contraste em pacientes com fatores de risco ou deteriora\u00e7\u00e3o p\u00f3s-operat\u00f3ria inexplicada.<sup>1<\/sup> Raramente, uma aparente autoinsufla\u00e7\u00e3o pode ser simulada por priapismo de alto fluxo decorrente de uma f\u00edstula arteriocavernosa, que foi identificada por ultrassonografia ou RM.<sup>11<\/sup><\/p>\n<p>Uma hernia\u00e7\u00e3o incidental sem dano aos tecidos adjacentes em um paciente assintom\u00e1tico n\u00e3o requer interven\u00e7\u00e3o, enquanto um reservat\u00f3rio mal posicionado que ameace estruturas adjacentes pode ser reposicionado cirurgicamente.<sup>6<\/sup> Os reparos descritos para a hernia\u00e7\u00e3o incluem uma sutura em bolsa para refor\u00e7ar o anel inguinal ou uma coloca\u00e7\u00e3o mais alta dentro do canal inguinal por meio de uma incis\u00e3o inguinal.<sup>3<\/sup> A autoinsufla\u00e7\u00e3o grave pode exigir uma capsulotomia para liberar e realinhar o reservat\u00f3rio.<sup>3<\/sup> A perfura\u00e7\u00e3o intestinal tardia, a eros\u00e3o ou a forma\u00e7\u00e3o de f\u00edstula geralmente exigem a explanta\u00e7\u00e3o do material prot\u00e9tico juntamente com reparo ou ressec\u00e7\u00e3o intestinal,<sup>1<\/sup> e, ap\u00f3s les\u00e3o ou eros\u00e3o da bexiga, o reservat\u00f3rio pode ser reimplantado no lado contralateral ou em um local ect\u00f3pico.<sup>3<\/sup> A compress\u00e3o venosa foi tratada com o reposicionamento do reservat\u00f3rio seguido de trombectomia venosa.<sup>9<\/sup><\/p>\n<p>A preven\u00e7\u00e3o baseia-se no cateterismo e esvaziamento da bexiga antes da coloca\u00e7\u00e3o, em um teste de contrapress\u00e3o ap\u00f3s o enchimento e em reservat\u00f3rios com v\u00e1lvulas de bloqueio projetadas para prevenir a autoinsufla\u00e7\u00e3o.<sup>7,12<\/sup> Uma contraincis\u00e3o pode reduzir o risco de localiza\u00e7\u00e3o inadequada, dobra e migra\u00e7\u00e3o.<sup>13<\/sup> Nos exames de imagem ap\u00f3s a coloca\u00e7\u00e3o transinguinal, a posi\u00e7\u00e3o final do reservat\u00f3rio varia, mas as complica\u00e7\u00f5es relacionadas ao reservat\u00f3rio permaneceram raras.<sup>14<\/sup><\/p>","gt-related-evidence":null,"gt-featured":false,"gt-ai-referenced":false,"gt-view-count":16},"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.7 (Yoast SEO v28.7) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Mau Posicionamento do Reservat\u00f3rio (IPP): Hernia\u00e7\u00e3o e Eros\u00e3o<\/title>\n<meta name=\"description\" content=\"Mau posicionamento do reservat\u00f3rio do implante peniano: hernia\u00e7\u00e3o, migra\u00e7\u00e3o, eros\u00e3o e autoinsufla\u00e7\u00e3o, como se apresentam, papel da TC e reparo cir\u00fargico.\" \/>\n<meta name=\"robots\" content=\"index, follow, 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