Artificial Urinary Sphincter Implantation for Severe Post-Prostatectomy Incontinence in Setting of Salvage Radiotherapy and Prior Inflatable Penile Prosthesis

Authors: Sean W. Hou, Caleb A. Cooper, Matthew J. Sloan, Omer A. Raheem

Key Words: artificial urinary sphincter, surgical technique, stress urinary incontinence, radiation therapy, penile implant

This video covers the surgical technique for implantation of an artificial urinary sphincter (AUS) for management of stress urinary incontinence (SUI). Notably, this patient underwent radical prostatectomy (RP) followed by salvage radiotherapy (XRT) for biochemical recurrence of prostate cancer and had prior inflatable penile prosthesis (IPP) placement. AUS implantation is one of the most common treatment options for individuals with severe SUI, which is a common complication after RP.1 The modern AUS consists of a urethral cuff, pump, and reservoir, which serve as a replacement of the native incompetent sphincter. There are various surgical approaches for AUS insertion, including transperineal, transscrotal, and abdominal approaches.2 We demonstrate a step-by-step technique for insertion of an AUS with a transperineal approach in the context of a patient with prior XRT and IPP placement.

Acknowledgements: None.

Disclosures: The authors have nothing to disclose.

References:

• James, M. H. & McCammon, K. A. Artificial urinary sphincter for post-prostatectomy incontinence: a review. Int. J. Urol. Off. J. Jpn. Urol. Assoc. 21, 536–543 (2014).
• Suarez, O. A. & McCammon, K. A. The Artificial Urinary Sphincter in the Management of Incontinence. Urology 92, 14–19 (2016).