Synchronous prosthetic implantation through a transscrotal incision: an outcome analysis.
OBJECTIVE
The ease of the transscrotal approach for penile prosthesis implantation and the proximity of the urethra has allowed the evolution of a new strategy for dual implantation of an AUS and IPP at a single setting. Concerns regarding increased infection rates and poor outcomes have prevented widespread acceptance of this simultaneous implantation technique. A multi-institutional evaluation of dual prosthesis implantation was performed to determine the overall efficacy, safety and long-term success of this innovative approach.


METHODS
We performed a multi-institutional, retrospective analysis in patients with 2 urological prostheses (AUS and IPP). Only patients undergoing dual implantation via a single transscrotal technique were included for evaluation. Comorbidities, infection rates, and intraoperative and postoperative complications were recorded.


RESULTS
A total of 22 men underwent AUS and IPP device implantation between 2000 and 2003 in a synchronous manner. Mean followup was 17 months. Complications were urethral erosion in 2 patients (9%) and reservoir migration in 2 (9%), of whom 1 underwent revision. Importantly no patient experienced a prosthetic infection postoperatively. The overall revision rate was 14%, due to urethral erosion of the AUS in 2 patients and reservoir migration in 1. All patients reported urinary leakage requiring 1 pad daily or less.


CONCLUSIONS
Our initial intermediate followup in patients who underwent synchronous dual prosthetic implantation was favorable. The inherent advantage of a single anesthetic event and a single transscrotal incision should encourage widespread acceptance of this technique.
Kendirci
Muammer
M
Department of Urology, Tulane University Health Sciences Center, New Orleans, Louisiana 70112, USA.
Gupta
Sanjeev
S
Shaw
Koushik
K
Morey
Allen
A
Jones
LeRoy
L
Hakim
Larry
L
Hellstrom
Wayne J G
WJ
D000368:Aged; D000369:Aged, 80 and over; D007172:Erectile Dysfunction / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019935:Penile Implantation / Q000379:methods*; D012611:Scrotum / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000150:complications / Q000601:surgery*; D016741:Urinary Sphincter, Artificial; D013521:Urologic Surgical Procedures, Male / Q000379:methods