Robert Andrianne1, Koenraad van Renterghem2
1: CHU Liege 2: Jessa hospital and University Hospitals Leuven
Introduction: In patients with climacturia or mild stress incontinence, scheduled for penile implant, a mini sling can be incorporated in the procedure.
Case presentation: A 63 year old patient with severe vascular co-morbidity underwent a RRns Prostatectomy 6 years ago because of a T2a G3 N0 M0 prostate cancer. Three years later a penile curvature developed with a 30 ° dorsal angle and some hourglass deformity. Furthermore there is a bothering problem of climacturia.
Outcome:This combined procedure resulted so far in a satisfactory outcome regarding erectile dysfunction and climacturia in 16 patients.
Discussion: The estimated rate of climacturia varies between 20 and 93 % in literature. More in detail urinary leakage occurs in 38 % of men after RR Prostatectomy during kissing, hugging, sexual foreplay, intercourse, orgasm. This provokes avoiding sexual activity in 25 % of men. Up till now available treatment is underwhelming.
In this video we use a transverse single incision penoscrotal approach. Our mini sling is fixed to the inner borders of both corporotomies which results in mild compression of the bulbo-urethral urethra when inflating the penile implant.