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Asian Journal of Andrology (2013) 15, 10β15; doi:10.1038/aja.2012.115; published online 3 December 2012
Simultaneous penile prosthesis and male sling/artificial urinary sphincter
Dominic Lee1, Claudio Romero2, Frances Alba2, O Lenaine Westney1 and Run Wang1,2
1 Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
2 Division of Urology, University of Texas Medical School at Houston, Houston, TX 77030, USA
Correspondence: Prof R Wang, (Run.Wang@uth.tmc.edu)
Received 2 September 2012; Revised 5 October 2012; Accepted 8 October 2012
Advance online publication 3 December 2012
| Abstract |
Erectile dysfunction (ED) and stress urinary incontinence (SUI) from urethral sphincteric deficiency is not an uncommon problem. The commonest etiology is intervention for localized prostate cancer and/or radical cystoprostatectomy for muscle invasive bladder cancer. Despite advances in surgical technology with robotic assisted laparoscopic prostatectomy and nerve sparing techniques, the rates of ED and SUI remain relatively unchanged. They both impact greatly on quality of life domains and have been associated with poor performance outcomes. Both the artificial urinary sphincter and penile prosthesis are gold standard treatments with proven efficacy, satisfaction and durability for end-stage SUI and ED respectively. Simultaneous prosthesis implantation for concurrent conditions has been well described, mostly in small retrospective series. The uptake of combination surgery has been slow due in part to technical demands of the surgery and to an extent, a heightened anxiety over potential complications. This paper aims to discuss the technical aspect of concurrent surgery for both disease entity and the current published outcomes of the various surgical techniques with this approach.
Keywords: artificial urinary sphincter; dual implants; erectile dysfunction; penile prosthesis; stress urinary incontinence |
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