V906: Simultaneous double implant: Artificial Urinary Sphincter and Penile Prosthesis using scrotal unique incision.
VideoIntroduction and Objectives
Radical prostatectomy (RP) is a common procedure in clinical practice in urology. Moderate to severe urinary incontinence and refractory erectile dysfunction after radical prostatectomy are two entities which worsen quality of life to patients.
To present the surgical technique in simultaneous dual implantation of artificial urinary sphincter (AUS) and penile prosthesis (PP) through scrotal unique incision.
Prospective outpatient evaluation was held. Most of our patients who are candidates for this approach had a previous radical prostatectomy (RP). Moderate to severe urinary incontinence (considered as use of > 3 pads / day) and erectile dysfunction with no response to first and second line therapies were selection criteria. Considerations and the most important technical steps of surgical procedure are described for simultaneous dual implantation.
Upper transverse scrotal incision is done. Following bulbar urethra dissection and AUS cuff is placed. Through the same window corpora cavernosa are exposed. We perform four stitches of absorbable 3/0 suture material; overhead traction is made followed by scalpel vertical corporotomy. Once measured proximally and distally with Furlow meter, the corresponding PP is implanted. Scott retractor is removed to proceed to reservoirs placement through the same incision. Prevesical reservoir location is accessed through the inguinal canal. Both pumps are introduced in the scrotum.
Routinely catheter 12-16F was left 24h, drain Blake type and 24h compression bandage
Double implant of penile prosthesis and artificial urinary sphincter through unique incision is a safe and effective option in patient with loss of quality of life after radical prostatectomy. Candidates must be properly informed and motivated.