V04-02: Autologous fascial Mini-Jupette sling for the management of post-prostatectomy climacturia
The Andrianne Mini-Jupette has been shown to be a feasible adjunct to an IPP in patients with post-radical prostatectomy (RP) minimal stress urinary incontinence (SUI) and climacturia. We describe a modified Mini-Jupette sling using autologous rectus fascial material.
We present the case of a 68 year old male with a history of RP 11 years ago. He reports significant post-operative erectile dysfunction, mild SUI (1 pad/day) and significant climacturia. He underwent placement of an AMS 700 CX IPP with concomitant placement of a modified Mini-Jupette sling which was constructed from autologous rectus fascia. Graft measurements were as follows: width 4.0cm, length 3.0cm, and surface area 12.0cm2.
The patient had an uneventful post-operative course and was discharged home on post-operative day 1. He was able to cycle his device early and began using his device 4 weeks after surgery with satisfactory functional and esthetic outcomes. He also reported complete resolution of his SUI and climacturia.
The use of autologous fascia for a Mini-Jupette sling may be a safe and viable alternative to biologic and synthetic slings for the management of post-RP climacturia and minimal SUI. Longer term follow-up is needed to assess its safety and efficacy.