Inflatable penile prostheses (IPP) and artificial urinary sphincters (AUS) are used to treat men with erectile dysfunction (ED) and stress urinary incontinence (SUI), respectively. After treatment of prostate cancer, men often experience ED and SUI. Dual prosthetic implantation can improve the quality of life of these men. We evaluated the reoperation outcomes in men who underwent dual implantation compared to each individually.
The New York State Department of Health Statewide Planning and Research Cooperative Database was queried for men who underwent IPP insertion, AUS insertion, or both between 2000 and 2014. The primary outcomes were IPP and AUS re-operation rates (revision, replacement, or removal). Multivariable regression analysis was performed to assess the association of dual implantation with reoperation. Adjusted time-to-event analysis was also performed.
Median follow-up for the IPP was 66 (IQR 25-118) months and for the AUS cohort was 69 (IQR 27-121) months. As compared with IPP alone, those with an IPP and AUS had a higher likelihood of undergoing an IPP reoperation at one year (OR 2.08, 95%CI 1.32-3.27, p<0.01) and at three years (OR 2.60, 95%CI 1.69-3.99, p<0.01). As compared with AUS alone, patients with IPP and AUS did not have a higher likelihood of undergoing AUS reoperation at 1 year (p=0.76) or at 3 years (p=0.73).
Combined IPP and AUS portends a higher likelihood for IPP reoperation at one and three years. AUS outcomes, however, remain comparable. These findings should be used to better counsel patients about the risk of reoperation when undergoing dual implantation.
The Journal of urology. 2018 Jul 27 [Epub ahead of print]
Neal Patel, Ron Golan, Joshua A Halpern, Tianyi Sun, Abena Denise Asafu-Adjei, Bilal Chughtai, Peter Stahl, Art Sedrakyan, James A Kashanian
Department of Urology, New York Presbyterian - Weill Cornell Medicine, New York, NY., Department of Health Services and Policy Research - Weill Cornell Medicine, New York, NY., Department of Urology, New York Presbyterian - Columbia University Medical Center, New York, NY., Department of Urology, New York Presbyterian - Weill Cornell Medicine, New York, NY. Electronic address: .