PURPOSE: Little data exist on outcomes for combined Inflatable Penile Prosthesis (IPP) and Artificial Urinary Sphincter (AUS) insertion for the treatment of erectile dysfunction (ED) and stress urinary incontinence (SUI).
The objective of this study was to assess patient outcomes for combined vs. single device implantation procedures at a single institution.
MATERIALS AND METHODS: A retrospective review of all patients undergoing IPP and AUS insertion at the Johns Hopkins Hospital from January 2000-December 2011 was performed. 55 combined procedures were performed, compared with 336 IPP and 279 AUS.
RESULTS: The surgical approaches consisted of penoscrotal incisions for IPP, and transperineal incisions for AUS cuff placement with a secondary lower abdominal incision for reservoir placement. Men undergoing combined implantation had a higher mean age, risk of prostate cancer diagnosis & treatment, and a lesser risk of Peyronie's disease compared to men undergoing IPP alone (allP < 0.05). Although the duration of surgery was significantly longer for the combined procedure (mean 218.1 minutes vs. 145.9 for IPP alone and 114.7 for AUS alone,P < 0.0001),occurrences of device infection, erosion or malfunction in patientswere not increased irrespective of combined or staged procedures ( P > 0.05).
CONCLUSION: Combined IPP-AUS and staged prosthetic implantations are feasible without increased risk of adverse outcomes compared to single prosthetic implantation. Patientswith concomitant ED and SUI should be counseledabout the possible advantages of this surgical option, which include a single anesthesia event and faster resumption of sexual activity and urinary control.
Written by:
Segal RL, Cabrini MR, Harris ED, Mostwin JL, Bivalacqua TJ, Burnett AL. Are you the author?
The James Buchanan Brady Urological Institute, The Johns Hopkins Medical Institutions, Baltimore MD.
Reference: J Urol. 2013 Jul 2. pii: S0022-5347(13)04826-X.
doi: 10.1016/j.juro.2013.06.084
PubMed Abstract
PMID: 23831315
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