Combination therapy for male erectile dysfunction and urinary incontinence

Area of Science:

• Urology
• Prosthetic Surgery

Background:

• Urinary incontinence (UI) and erectile dysfunction (ED) are prevalent, often co-occurring conditions, particularly in aging populations and after prostate cancer treatment.
• The increasing incidence of concurrent UI and ED necessitates effective treatment strategies, especially in younger patients post-radical prostatectomy.

Observation:

• The article reviews evidence for simultaneous surgical management of male ED and UI using prosthetic devices, including artificial urinary sphincters (AUS) and penile prostheses (PP).
• The review also considers the concomitant insertion of PP with a male perineal sling for selected patients.

Findings:

• Simultaneous or staged insertion of AUS and PP is a safe, efficacious, and durable treatment for concurrent UI and ED.
• Advancements in device design and surgical techniques, like the single transverse scrotal incision, facilitate simultaneous implantation.
• Dual implantation of PP and male sling shows promise in specific patient groups.

Implications:

• Simultaneous AUS and PP implantation offers potential benefits in reduced operative and recovery times.
• This combination therapy is associated with high patient satisfaction and should be considered a valuable treatment option for concurrent UI and ED.
• The findings support the inclusion of combined prosthetic surgery in the treatment armamentarium for these conditions.