564 OUTCOMES OF COMBINED INFLATABLE PENILE PROSTHESIS-ARTIFICIAL URINARY SPHINCTER VS. INDIVIDUAL DEVICE INSERTION-A RETROSPECTIVE SINGLE INSTITUTION STUDY

Abstract

You have accessJournal of UrologyUrodynmaics/Incontinence/Female Urology: Incontinence, Evaluation & Therapy (I)1 Apr 2013564 OUTCOMES OF COMBINED INFLATABLE PENILE PROSTHESIS-ARTIFICIAL URINARY SPHINCTER VS. INDIVIDUAL DEVICE INSERTION-A RETROSPECTIVE SINGLE INSTITUTION STUDY Robert Segal, Marcelo Cabrini, Elaine Harris, Zhaoyong Feng, Bruce Trock, Jacek Mostwin, Trinity Bivalacqua, and Arthur Burnett Robert SegalRobert Segal Baltimore, MD More articles by this author , Marcelo CabriniMarcelo Cabrini Baltimore, MD More articles by this author , Elaine HarrisElaine Harris Baltimore, MD More articles by this author , Zhaoyong FengZhaoyong Feng Baltimore, MD More articles by this author , Bruce TrockBruce Trock Baltimore, MD More articles by this author , Jacek MostwinJacek Mostwin Baltimore, MD More articles by this author , Trinity BivalacquaTrinity Bivalacqua Baltimore, MD More articles by this author , and Arthur BurnettArthur Burnett Baltimore, MD More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.1960AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES There is a relative paucity of data on outcomes for combined 3-piece Inflatable Penile Prosthesis (IPP) and Artificial Urinary Sphincter (AUS) Insertion for the definitive treatment of erectile dysfunction and male stress incontinence, respectively. The objective of this study was to assess and compare patient demographics and outcomes for combined procedures vs. procedures wherein 1 individual device is implanted at a single institution. METHODS A retrospective review of all patients undergoing IPP and AUS insertion at the Johns Hopkins Hospital from January 2000-December 2011 was performed. A total of 54 combined procedures were performed, compared with 337 IPP and 281 AUS procedures. Comparisons between groups were performed using Chi-square tests for categorical data; the means of continuous data were compared by using the t test and non-parametric alternate if the distribution could not be normalized or the variance was not equal. All statistical tests were two sided and P < 0.05 was considered statistically significant. RESULTS The surgical approaches consisted of midline penoscrotal incisions for IPP, and transperineal incisions for AUS cuff placement with a secondary lower abdominal incision for AUS reservoir placement. Significant demographic differences between groups included those men undergoing combined implantation having a higher mean age (65.3 years vs. 59.9 years), risk of prostate cancer, prostatectomy and radiation therapy, and a lesser risk of Peyronie's disease, compared to men undergoing IPP alone (all P < 0.05). Although the duration of surgery was significantly longer for the combined procedure (mean 218.1 minutes vs. 145.9 minutes for IPP alone and 114.7 minutes for AUS alone, P < 0.0001), there was no increased risk of device infection, erosion or malfunction requiring surgical revision in the patients who received combined procedures (P = 0.37). Mean hospitalization duration for the combined procedure was 1.2 days (with 45/54 [83.3%] staying <24 hours), and mean follow-up for the combined procedure was 1.62 years, for IPP alone was 1.47 years, and for AUS alone, 2.98 years. CONCLUSIONS Combined IPP-AUS insertion is a safe procedure with no increased risk of adverse outcomes compared to individual prosthetic implantation. Patients should be counseled about this surgical option given the clear benefits of this approach, which include a single anesthesia event and faster restoration of erectile function and continence. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e231-e232 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Robert Segal Baltimore, MD More articles by this author Marcelo Cabrini Baltimore, MD More articles by this author Elaine Harris Baltimore, MD More articles by this author Zhaoyong Feng Baltimore, MD More articles by this author Bruce Trock Baltimore, MD More articles by this author Jacek Mostwin Baltimore, MD More articles by this author Trinity Bivalacqua Baltimore, MD More articles by this author Arthur Burnett Baltimore, MD More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...