Pd46-06 Cuff Conundrum: Inflatable Penile Prothesis Surgery in Men Following Transcorporal Artificial Urinary Sphincter

You have accessJournal of UrologySexual Function/Dysfunction: Surgical Therapy I (PD46)1 May 2024PD46-06 CUFF CONUNDRUM: INFLATABLE PENILE PROTHESIS SURGERY IN MEN FOLLOWING TRANSCORPORAL ARTIFICIAL URINARY SPHINCTER Garrett N. Ungerer, Alex Pinkhasov, Matthew Ziegelmann, Daniel Elliott, and Tobias Kohler Garrett N. UngererGarrett N. Ungerer , Alex PinkhasovAlex Pinkhasov , Matthew ZiegelmannMatthew Ziegelmann , Daniel ElliottDaniel Elliott , and Tobias KohlerTobias Kohler View All Author Informationhttps://doi.org/10.1097/01.JU.0001008900.49567.2e.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Concerns exist when inflatable penile prosthesis (IPP) surgery is performed following transcorporal artificial urinary sphincter (TC-AUS) due to risk of AUS cuff damage during proximal corporal dilation and device placement. We aim to describe perioperative complications, infections, revision rates, and device longevity when IPP is placed with prior TC-AUS in place. METHODS: A retrospective search identified all patients who underwent TC-AUS placement at a single institution from 2015-2023. Patients who then underwent IPP placement following TC-AUS at the same institution were included. IPPs were placed in standard fashion with additional care taken to avoid the AUS device and preferential use of electrocautery over sharp dissection. Data collected included demographics, operative details, perioperative complications, infections, revision rates, and device longevity. RESULTS: 727 patients underwent TC-AUS placement from 2015-2023. Of these, 13 patients underwent subsequent IPP placement (Figure 1). All patients had history of prostatectomy, and 6 (46%) patients had prior radiation. The median follow-up after IPP was 31.7 months and the time gap between AUS and IPP averaged 18.3 months (range 2.3 to 56.7 months). Average operative time for IPP was 85 minutes (range 53 to 202 minutes). IPP reservoirs were all placed contralateral to the AUS reservoir to minimize risk of injury to the AUS device. 8 patients had a 12 Fr catheter left post-operatively for less than 24 hours. Proximal dilation was noted to be difficult in 2 patients (15%), both of which were successfully dilated without perforation or damage to the AUS cuff. No infections or erosions occurred. 3 patients (23%) developed mechanical failure at a mean time of 28.7 months following IPP placement (36.5 months after AUS surgery). Cuff leak was identified in 2 patients, and the third has yet to undergo revision surgery to determine etiology. CONCLUSIONS: IPP surgery appears safe and effective in men who have previously undergone TC-AUS without increased risk of infection or device erosion. Care should be taken when dilating proximally, though proximal dilation was uneventful in most patients. Mechanical failure rates may be slightly higher compared to patients who have either device alone, and patients should be counseled accordingly. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e975 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Garrett N. Ungerer More articles by this author Alex Pinkhasov More articles by this author Matthew Ziegelmann More articles by this author Daniel Elliott More articles by this author Tobias Kohler More articles by this author Expand All Advertisement PDF downloadLoading ...