031 Modified-Approach for "Mini Male Urethral Sling" Placement with Inflatable Penile Prosthesis for Erectile Dysfunction and Climacturia or Mild Stress Urinary Incontinence: A Two-center Experience

Abstract

Climacturia with or without stress urinary incontinence (SUI) is commonly encountered with erectile dysfunction (ED) after prostate cancer treatment. Previous work has suggested that placement of the Adrianne mini-jupette graft with inflatable penile prosthesis can significantly improve these bothersome symptoms. We sought to describe our modified technique for placement of a “mini male sling” (MMS) at the time of penile prosthesis (PP) placement for men with ED and climacturia with or without mild SUI and assess early postoperative outcomes from two centers. A retrospective review was performed for patient who underwent IPP and MMS placement with Virtue sling mesh or Tutoplast human pericardium (Coloplast Corp, Minneapolis, MN) by two high-volume prosthetic surgeon between 2016-2018 using a similar technique. After proximal exposure, the MMS is sutured to the corpora at the level of the bulbar urethra, proximal to the planned corporotomies. Care is taken to avoid excessive tension on the urethra. Changes in patient-reported climacturia and pads per day (PPD) for SUI assessed pre-operatively and at each post-operative visit were compared for each patient using McNemar’s test with a statistical significance threshold of p<0.05.