title: Simultaneous penile prosthesis and male sling/artificial urinary sphincter.
abstract: Erectile dysfunction (ED) and stress urinary incontinence (SUI) from urethral sphincteric deficiency is not an uncommon problem. The commonest etiology is intervention for localized prostate cancer and/or radical cystoprostatectomy for muscle invasive bladder cancer. Despite advances in surgical technology with robotic assisted laparoscopic prostatectomy and nerve sparing techniques, the rates of ED and SUI remain relatively unchanged. They both impact greatly on quality of life domains and have been associated with poor performance outcomes. Both the artificial urinary sphincter and penile prosthesis are gold standard treatments with proven efficacy, satisfaction and durability for end-stage SUI and ED respectively. Simultaneous prosthesis implantation for concurrent conditions has been well described, mostly in small retrospective series. The uptake of combination surgery has been slow due in part to technical demands of the surgery and to an extent, a heightened anxiety over potential complications. This paper aims to discuss the technical aspect of concurrent surgery for both disease entity and the current published outcomes of the various surgical techniques with this approach.
authors.affiliation: Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
authors.forename: Dominic
authors.initials: D
authors.lastname: Lee
authors.forename: Claudio
authors.initials: C
authors.lastname: Romero
authors.forename: Frances
authors.initials: F
authors.lastname: Alba
authors.forename: O Lenaine
authors.initials: OL
authors.lastname: Westney
authors.forename: Run
authors.initials: R
authors.lastname: Wang
mesh_terms: D007172:Erectile Dysfunction / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D015917:Penile Prosthesis; D011183:Postoperative Complications / Q000601:surgery; D011468:Prostatectomy / Q000009:adverse effects; D011471:Prostatic Neoplasms / Q000601:surgery; D019919:Prosthesis Implantation / Q000379:methods; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000209:etiology / Q000601:surgery*; D016741:Urinary Sphincter, Artificial