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  • Review Article
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Synchronous surgery for the combined treatment of post-radical prostatectomy erectile dysfunction and stress urinary incontinence: a lucrative evolution or an unnecessary complexity?

International Journal of Impotence Research volume 33, pages 6–15 (2021)Cite this article

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Abstract

Aim of this review is to summarize and evaluate the current literature addressing the synchronous combined surgical treatment approach for co-existent post-radical prostatectomy erectile dysfunction and stress urinary incontinence. Severity of stress urinary incontinence is the basic element that defines which option of combined surgery will be offered to a patient. So, for cases of severe erectile dysfunction and severe stress urinary incontinence (>4 pads/day) the only available option is synchronous inflatable penile prosthesis plus artificial urinary sphincter dual implantation. When severe erectile dysfunction coexist with mild to moderate stress urinary incontinence synchronous inflatable penile prosthesis plus male sling or ProAct (Uromedica, Plymouth, MN, USA) device are the current available treatment options. Finally, when severe erectile dysfunction along with mild stress urinary incontinence and with or without climacturia are present, a new surgical technique of simultaneous inflatable penile prosthesis plus urethral mini-sling, named “Andrianne mini-jupette”, implantation has been recently proposed. Synchronous combined surgery for post-radical prostatectomy erectile dysfunction and stress urinary incontinence seems to offer similar efficacy and safety results compared with two-stage implantation but in a more cost- and time effective approach. Thus, synchronous surgery, in the hands of experienced prosthetic surgeons, could be potentially a valuable alternative for the management of co-existent post-radical prostatectomy erectile dysfunction and stress urinary incontinence. Nevertheless, in order to acquire robust scientific data further prospective comparative studies on larger numbers of patients are surely needed.

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Fig. 1
Fig. 2: IPP plus “Andrianne mini-jupette” sling.

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Authors and Affiliations

  1. Centre Hospitalier Universitaire de Liège, Service d’Urologie, Liège, Belgium

    Ioannis Mykoniatis, Robert Andrianne & Maxime Sempels

  2. Department of Urology, Jessa Hospital, Hasselt, Belgium

    Ioannis Mykoniatis & Koenraad van Renterghem

  3. Department of Urology, University Hospitals of Leuven, Leuven, Belgium

    Ioannis Mykoniatis, Maarten Albersen & Koenraad van Renterghem

  4. Department of Urology, Martha-Maria Hospital Nuremberg, Nuremberg, Germany

    Ioannis Sokolakis & Georgios Hatzichristodoulou

  5. Faculty of medicine, Hasselt University, Hasselt, Belgium

    Koenraad van Renterghem

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  1. Ioannis Mykoniatis
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Correspondence to Ioannis Mykoniatis.

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Mykoniatis, I., Albersen, M., Andrianne, R. et al. Synchronous surgery for the combined treatment of post-radical prostatectomy erectile dysfunction and stress urinary incontinence: a lucrative evolution or an unnecessary complexity?. Int J Impot Res 33, 6–15 (2021). https://doi.org/10.1038/s41443-020-0253-5

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