303 ‘Mini Male Urethral Sling’ and Inflatable Penile Prosthesis for the Treatment of Erectile Dysfunction with Climacturia

Abstract

A ‘mini male sling’ (MMS) is a urethral sling designed to treat climacturia, urinary incontinence at the time of ejaculation. The MMS is composed of either human cadaveric pericardium or macroporous monofilament polypropylene mesh and is sutured to the ventral bilateral corpora cavernosa proximal to the corporotomies for inflatable penile prosthesis (IPP) placement at the level of the bulbar urethra. For men who experience erectile dysfunction and climacturia post prostatectomy, we hypothesized that placement of an IPP and a MMS would result in significant improvement in patient-reported climacturia and mild stress urinary incontinence as measured by pad use. A retrospective review was performed for all consecutive patients (n=20) who underwent IPP and MMS placement by a single surgeon between 2016-2017. Patient-reported climacturia and number of pads used daily for mild stress urinary incontinence were assessed pre-operatively and at each post-operative visit starting at 2 post-operative weeks for mild stress urinary incontinence and starting at 3 post-operative months for climacturia. Pre-operative to post-operative patient reported climacturia and pad use were compared for each patient using McNemar’s test with a statistical significance threshold of p<0.05.