Treatment of Urinary Incontinence in Patients With Erectile Dysfunction - Beyond the Abstract

The treatment of various pelvic ailments can be complicated by erectile dysfunction (ED) and urinary incontinence (UI). These are damaging to a patient’s quality of life. 


While these are sometimes treated concurrently, in our experience, ED and UI are being treated different subspecialists – genitourinary reconstructive urological surgeons (GURS) for UI and sexual medicine experts for ED. The goal of our paper is to help the UI surgeon be mindful of concurrent or subsequent ED treatments. This article is a review of the epidemiology, workup, and management of UI while being cognizant of ED treatments that may occur concurrently or subsequently. 

We describe a comprehensive workup of UI, including a checklist that can be used when evaluating patients for the first time. Next, we review treatment options for UI including pelvic floor physical therapy, barrier and storage devices, intraurethral injectables, and surgical options including transobturator male sling, other adjustable and fixed slings, Pro-ACT system, and multiple approaches to the artificial urinary sphincter. We highlight surgical considerations for a patient who may undergo concurrent or subsequent ED treatments. Lastly, we review the literature for and against dual implantation and the treatment of climacturia. 

Written by: Divya Ajay, Melissa H Mendez, Run Wang, O Lenaine Westney

Urinary Tract and Pelvic Reconstruction fellow, Department of Urology, University of Texas, MD Anderson Cancer Center, Houston, TX, USA. Electronic address: ., Sexual Medicine and Genital Reconstruction fellow, Department of Urology, University of South Florida, Tampa, FL, USA., Professor, Department of Urology, University of Texas McGovern Medical School and MD Anderson Cancer Center, Houston, TX, USA., Professor, Department of Urology, University of Texas, MD Anderson Cancer Center, Houston, TX, USA.



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