Surgical Implantation of Artificial Urinary Device and Penile Prosthesis Through Trans-scrotal Incision for Postprostatectomy Urinary Incontinence and Erectile Dysfunction: Synchronous or Delayed Procedure?

Rolle, Luigi; Ceruti, C.; Sedigh, O.; Timpano, M.; Destefanis, Paolo; Lillaz, B.; Galletto, E.; Maria, C. De; Falcone, Marco; Dalmasso, Ettore; Fontana, Dario

doi:10.1016/j.urology.2012.08.003

Cited by 30 publications

(21 citation statements)

References 29 publications

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“…This observation may relate to the national nature of our dataset, which may include many surgeons with different levels of experience. However, it was similar to Rolle et al's study [11] on 15 patients who had dual PP and AUS with LOS of 2.5 days.…”

Section: Discussionsupporting

confidence: 87%

“…Despite the growing evidence supporting dual implantation to manage both ED and SUI following RP, there are financial constraints placed upon reimbursement of two implants placed concurrently in the same patient by 3rd party payers. Many insurances and Medicare do not reimburse the whole cost of the second implant to the hospital and 50% the surgeon charge [11][12][13]. Because of the financial problems with doing a dual IPP+AUS implant, this study aims to assess the 30-day postoperative morbidity in patients undergoing combined placement of PP+AUS vs. PP+MS.…”

Section: Introductionmentioning

confidence: 99%

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Concurrent Penile Prosthesis and Artificial Urinary SphincterversusPenile Prosthesis and Male Sling: A National Multi-Institutional Analysis of National Surgical Quality Improvement Program Database Comparing Postoperative Morbidity

Khalil

Bramwell

Bhandari

et al. 2021

World J Mens Health

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Purpose: We aimed to assess the 30-day morbidity in patients undergoing combined insertion of penile prosthesis (PP) and artificial urinary sphincter (AUS) vs. PP and male sling (MS). Materials and Methods: The National Surgical Quality Improvement Program database was queried to identify patients who underwent placement of AUS or MS combined with PP. Patient demographics, postoperative morbidity including complications, readmission and reoperation rates were recorded. Student t-test and chi-square or Fischer's exact test were used as appropriate. Results: Forty-one patients met selection criteria between 2010 and 2016. Overall, 26 patients received PP and AUS vs. 15 that received PP and MS. Average age was similar in both groups (64.8±6.6 years vs. 62.3±6.3 years, p=0.254). Diabetes mellitus was more prevalent in PP+MS group compared to AUS+PP group (46.7% vs. 11.5%, p=0.022). Average length of stay was higher in PP+AUS group compared to PP+MS group (2.2±0.6 days vs. 1.8±0.4 days, p=0.017). Postoperative morbidity was reported in four patients in PP+AUS group. No reported complications in PP+MS group. In PP+AUS group, complications included one patient who developed urinary tract infection, one developed surgical site infection, readmission in two for postoperative infection, and one return to the operating room. No reported prosthesis explantation or revision in either groups. Conclusions: Our results showed that 30-day morbidity was recorded in the PP+AUS group and none in the PP+MS group. The complication and readmission rates remain comparable to the previous reports in both groups.

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Concurrent Penile Prosthesis and Artificial Urinary SphincterversusPenile Prosthesis and Male Sling: A National Multi-Institutional Analysis of National Surgical Quality Improvement Program Database Comparing Postoperative Morbidity

Khalil

Bramwell

Bhandari

et al. 2021

World J Mens Health

View full text Add to dashboard Cite

show abstract

“…Rolle et al compared the simultaneous and the two-stage surgical implantation procedures, with data available for 15 and eight patients, respectively. 9 Results in terms of QoL were similar if devices were placed simultaneously or in a two-stage procedure. There were no differences in patient satisfaction or functional outcome between the two groups.…”

Section: Discussionmentioning

confidence: 84%

“…However, this was not recommended as long-term leakage due to muscle atrophy has been described. 9 Once cuff size was determined, air was evacuated from the cuff before final placement.…”

Section: Methodsmentioning

confidence: 99%

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Management of end-stage erectile dysfunction and stress urinary incontinence after radical prostatectomy by simultaneous dual implantation using a single trans-scrotal incision: surgical technique and outcomes

et al. 2015

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Stress urinary incontinence (SUI) and end-stage erectile dysfunction (ED) after radical prostatectomy (RP) can decrease a patient's quality of life (QoL). We describe a surgical technique involving scrotal incision for simultaneous dual implantation of an artificial urinary sphincter (AUS) and an inflatable penile prosthesis (IPP). Patients with moderate to severe SUI (>3 pads per day) and end-stage ED following RP were selected for dual implantation. An upper transverse scrotal incision was made, followed by bulbar urethra dissection and AUS cuff placement. Through the same incision, the corpora cavernosa was exposed, and an IPP positioned. Followed by extraperitoneal reservoirs placement and pumps introduced in the scrotum. Short-term, intra- and post-operative complications; continence status and erectile function; and patient satisfaction and QoL were recorded. A total of 32 patients underwent dual implantation. Early AUS-related complications were: AUS reservoir migration and urethral erosion. One case of distal corporal extrusion occurred. No prosthetic infection was reported. Over 96% of patients were socially the continent (≤1 pad per day) and > 95% had sufficient erections for intercourse. Limitations of the study were the small number of patients, the lack of the control group using a perineal approach for AUS placement and only a 12 months follow-up. IPP and AUS dual implantation using a single scrotal incision technique is a safe and effective option in patients with SUI and ED after RP. Further studies on larger numbers of patients are warranted.

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Dual Implantation of Inflatable Penile Prosthesis and Artificial Urinary Sphincter or Male Sling: Benefits and Risks

Loh-Doyle

Martins

Boyd

2019

Textbook of Male Genitourethral Reconstruction

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Surgical Implantation of Artificial Urinary Device and Penile Prosthesis Through Trans-scrotal Incision for Postprostatectomy Urinary Incontinence and Erectile Dysfunction: Synchronous or Delayed Procedure?

Cited by 30 publications

References 29 publications

Concurrent Penile Prosthesis and Artificial Urinary SphincterversusPenile Prosthesis and Male Sling: A National Multi-Institutional Analysis of National Surgical Quality Improvement Program Database Comparing Postoperative Morbidity

Concurrent Penile Prosthesis and Artificial Urinary SphincterversusPenile Prosthesis and Male Sling: A National Multi-Institutional Analysis of National Surgical Quality Improvement Program Database Comparing Postoperative Morbidity

Management of end-stage erectile dysfunction and stress urinary incontinence after radical prostatectomy by simultaneous dual implantation using a single trans-scrotal incision: surgical technique and outcomes

Dual Implantation of Inflatable Penile Prosthesis and Artificial Urinary Sphincter or Male Sling: Benefits and Risks

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