Autologous fascial Mini-Jupette sling for the management of post-prostatectomy climacturia

Author(s): Judy Choi, Zhamshid Okhunov, Francis Jefferson, Farouk M. El-Khatib, Catherine Nguyen, James Furr, Faysal A. Yafi
Department of Urology, University of California, Irvine, CA, USA

Key words: Mini-Jupette, penile prosthesis, sling, climacturia, stress urinary incontinence, erectile dysfunction

The Andrianne Mini-Jupette has been shown to be a feasible adjunct to an IPP in patients with post-radical prostatectomy (RP) minimal stress urinary incontinence (SUI) and climacturia1. We describe a modified Mini-Jupette sling using autologous rectus fascial material. We present the case of a 68 year old male with a history of RP 11 years ago. He reports significant post-operative erectile dysfunction, mild SUI (1 pad/day) and significant climacturia. He underwent placement of an AMS 700 CX IPP with concomitant placement of a modified Mini-Jupette sling which was constructed from autologous rectus fascia. Graft measurements were as follows: width 4.0cm, length 3.0cm, and surface area 12.0cm2. The patient had an uneventful post-operative course and was discharged home on post-operative day 1. He was able to cycle his device early and began using his device 4 weeks after surgery with satisfactory functional and esthetic outcomes. He also reported complete resolution of his SUI and climacturia. The use of autologous fascia for a Mini-Jupette sling may be a safe and viable alternative to biologic and synthetic slings for the management of post-RP climacturia and minimal SUI. Longer term follow-up is needed to assess its safety and efficacy.

Acknowledgements: none

Disclosures: FAY: Antares Pharma: Consultant, Speaker Bureau; Boston Scientific: Consultant; Coloplast: Consultant; Endo Pharmaceuticals: Consultant, Speaker Bureau

References: Yafi FA, Andrianne R, Alzweri L, Brady J, Butcher M, Chevalier D, DeLay KJ, Faix A, Hatzichristodoulou G, Hellstrom WJG, Jenkins L, Kohler TS, Osmonov D, Park SH, Schwabb MD, Valenzuela R, van Renterghem K, Wilson SK. Andrianne Mini-Jupette Graft at the Time of Inflatable Penile Prosthesis Placement for the Management of Post-Prostatectomy Climacturia and Minimal Urinary Incontinence, J Sex Med, 2018; 15(5):789-796.