Dual implantation of penile and sphincter implants in the post-prostatectomy patient

Despite major improvement in surgical techniques for radical pelvic surgery, including radical prostatectomy, major quality-of-life issues persist, such as postoperative erectile dysfunction and urinary incontinence. These two conditions have many common etiologies and often occur in the same patient. Patients with either of these conditions fail initial conservative or minimally invasive therapy and become candidates for prosthetic implants, such as artificial urinary sphincter and penile prosthesis. In the past three decades, there have been significant improvements in the mechanical properties of these devices, their functional capabilities, and surgical implantation techniques. Studies once suggested that implantation of both devices in one patient could lead to failure, but recent literature proves that patients benefit from simultaneous dual implantation. Specific benefits relate to shorter surgery time, with potentially lower infection rates. In this manuscript, we review the indications, techniques, merits, and safety of simultaneous dual implantation of the artificial urinary sphincter and penile prosthesis in the post-radical prostatectomy patient.