title: [Initial experience combinating transobturator male sling and penile implant after radical prostatectomy].
abstract: OBJECTIVE
  Stress urinary incontinence (SUI) and erectile dysfunction (ED) are two major complications following radical prostatectomy (RP). In case of failure of medical treatment, Advance™ retrourethral male sling and penile implant are validated options to manage respectively SUI and ED. Our goal was to assess the feasibility and results of the combination of these two devices.
  
  
  METHODS
  Four patients were treated for SUI and DE following RP in our institution by retrourethral sling and penile prosthesis, after failure of medical management. Each patient was preoperatively evaluated by age, complete medical history, ASA score, endoscopy, pad-test, and urodynamics. The first two patients were implanted with the two devices in a two-stage procedure: retrourethral sling then penile prosthesis for one, and penile prosthesis then retrourethral sling for the other. The two other patients underwent a one-stage procedure: one received the two devices, and the other had retrourethral sling implantation and replacement of a penile prosthesis. Post-operative follow-up was focused on complications and efficacy (evaluated by pad use and PGI-I questionnaire for continence, and patient auto-evaluation for sexual function).
  
  
  RESULTS
  No perioperative complication occurred. After a minimum of 6 months follow-up, all the four patients were pad-free with no leakage reported, feeling very much better after the procedure according to the PGI-I. The four patients were fully satisfied of the penile implant device.
  
  
  CONCLUSIONS
  According to our initial experience, surgery combining the transobturator Advance male sling and a penile prosthesis is feasible, successively or simultaneously, and leads to excellent functional results with no complications.
authors.affiliation: Service d'urologie, hôpital Tenon, université Paris VI, groupe hospitalo-universitaire Est, Assistance publique-Hôpitaux de Paris, 4, rue de la Chine, 75970 Paris cedex 20, France. jncornu@hotmail.fr
authors.forename: J-N
authors.initials: JN
authors.lastname: Cornu
authors.forename: T
authors.initials: T
authors.lastname: Chanu
authors.forename: S
authors.initials: S
authors.lastname: Beley
authors.forename: P
authors.initials: P
authors.lastname: Sèbe
authors.forename: L
authors.initials: L
authors.lastname: Peyrat
authors.forename: C
authors.initials: C
authors.lastname: Ciofu
authors.forename: F
authors.initials: F
authors.lastname: Haab
mesh_terms: D000368:Aged; D003131:Combined Modality Therapy; D007172:Erectile Dysfunction / Q000209:etiology* / Q000601:surgery*; D005240:Feasibility Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015917:Penile Prosthesis; D011446:Prospective Studies; D011468:Prostatectomy / Q000009:adverse effects* / Q000379:methods; D053825:Suburethral Slings; D014550:Urinary Incontinence, Stress / Q000209:etiology* / Q000601:surgery*