298 A Modified-approach for Placement of a “Mini-sling” at the Time of Inflatable Penile Prosthesis Implantation for Post-prostatectomy Climacturia and Mild Stress Urinary Incontinence

Abstract

Climacturia with or without stress urinary incontinence (SUI) is commonly seen in conjunction with erectile dysfunction (ED) after radical prostatectomy. Previous work has suggested that placement of the Adrianne mini-jupette graft with inflatable penile prosthesis can significantly improve these bothersome symptoms. To describe our modified “mini-sling” technique at the time of IPP placement and report early postoperative outcomes. We identified patients who underwent concurrent “mini-sling” at the time of IPP placement via a penoscrotal approach by a single surgeon at a tertiary care center. After corporal body exposure including takedown of the central tendon to gain further proximal exposure, the arms of the Virtue sling (Coloplast Corp, Minneapolis, MN, USA) are removed leaving a 3-cm x5.5-cm piece of mesh. This is brought to the field, sized appropriately, and sutured to the lateral corporal bodies in an area proximal to the area of planned corporotomies. Care is taken to avoid excessive tension on the underlying urethra. Subsequent IPP placement is performed in standard fashion. Sling tension is then re-assessed with the IPP fully inflated. Patient demographics and clinical outcomes were assessed via chart review.