202 Outcomes of Dual Inflatable Penile Prosthesis and Artificial Urinary Sphincter Implantation After Radical Cystectomy and Neobladder

Abstract

After radical cystectomy (RC) and orthotopic neobladder (ONB), post-operative complications such as erectile dysfunction and stress urinary incontinence can arise. While combined prosthetic reconstruction can treat both these issues, the feasibility and viability of dual implantation has not been studied in this unique subset of patients. To examine the outcomes of male patients who have undergone placement of both an artificial urinary sphincter (AUS) and 3-piece inflatable penile prosthesis (IPP) after RC and ONB diversion. Using a prospectively-maintained IRB-approved institutional database, we identified 39 patients who underwent RC and NB and subsequent implantation of an AUS and IPP from 2003 to 2017. Patients were included if they had devices placed synchronously or metachronously. Two patients with follow-up duration less than 12 months were excluded from analysis. An infrapubic approach was used in most patients for IPP placement, with reservoir placement in the lateral retroperitoneal space through a counter-incision medial to the anterior superior iliac spine. AUS placement was performed using a transperineal incision in all patients. 12 patients underwent synchronous device placement. Patient demographics, perioperative data, and postoperative outcomes including prosthetic infection, mechanical failure, and revision surgery were examined and statistical analysis was performed.