Technique for concomitant implantation of the penile prosthesis with the male sling.

Abstract

PURPOSE: We describe an initial experience with a technique for concomitant implantation of inflatable and semirigid penile prostheses with the synthetic male sling. In 4 cases the simultaneous procedures for erectile dysfunction and urinary incontinence were achieved successfully. MATERIALS AND METHODS: Four patients presented with post-prostatectomy urinary incontinence and erectile dysfunction. They underwent treatment with placement of a synthetic (silicone coated polypropylene) perineal male sling with concomitant placement of a penile prosthesis, as performed by a single surgeon. The patients underwent the male sling procedure using 6 bone screws drilled into the descending pelvic rami bilaterally and a 4 x 7 cm silicone coated polymer mesh. Patients simultaneously also underwent placement of a semirigid or inflatable penile implant. Clinical outcome was determined via physician and patient assessment of continence and a continence questionnaire. RESULTS: No perioperative complications occurred. All patients were discharged home within 24 hours of the procedures and postoperative pain was controlled with oral medications. One-year followup showed complete satisfaction in all 4 patients with continent status and erectile function. CONCLUSIONS: Our initial experience shows that concomitant placement of the male sling and a semirigid or inflatable penile implant can be successfully accomplished with high satisfaction.