Urinary incontinence (UI) and erectile dysfunction (ED) are both very prevalent conditions. Insertion of an artificial urinary sphincter (AUS) and penile prosthesis (PP) is an effective and proven method of treatment for both conditions. With advancing age, as well as with increasing populations of patients radically treated for prostate cancer, the occurrence of both conditions found in the same patient is increasing. The purpose of this article was to analyze the available evidence for simultaneous surgical management of male ED and UI using prosthetic devices. The existing literature pertaining to dual implantation of AUS and PP was reviewed. The concomitant insertion of the PP with the male perineal sling was also considered. Concurrent ED and UI are increasingly seen in the post radical prostatectomy population, who are often younger and less willing to suffer with these conditions. Insertion of an AUS and PP, either simultaneously or as a two-stage procedure, appears to be a safe, efficacious and long-lasting method of treatment. The improvements in design of both the AUS and PP as well as the development of the single transverse scrotal incision have made simultaneous insertion of these prostheses possible. Dual implantation of the PP and male sling looks promising in a selected population. In conclusion, the insertion of the AUS and PP for the treatment of concurrent UI and ED is safe and effective. Simultaneous insertion of these prostheses in the same patient offers potential advantages in operative and recovery time and is associated with high patient satisfaction. Combination therapy should therefore be included in the arsenal of treatment of these conditions.
Equipment Failure ; statistics & numerical data ; Erectile Dysfunction ; complications ; surgery ; History, 20th Century ; Humans ; Male ; Penile Implantation ; methods ; Penile Prosthesis ; Postoperative Complications ; epidemiology ; Prosthesis Implantation ; methods ; Treatment Outcome ; Urinary Incontinence ; complications ; surgery ; Urinary Sphincter, Artificial

With the onset of a metabolic syndrome epidemic and the increasing life expectancy, erectile dysfunction (ED) has become a more common condition. As incidence and prevalence increase, the medical field is focused on providing more appropriate therapies. It is common knowledge that ED is a chronic condition that is also associated with a myriad of other disorders. Conditions such as aging, diabetes mellitus, hypertension, obesity, prostatic hypertrophy, and prostate cancer, among others, have a direct implication on the onset and progression of ED. Characterization and recognition of risk factors may help clinicians recognize and properly treat patients suffering from ED. One of the most reliable treatments for ED is penile prosthetic surgery. Since the introduction of the penile prosthesis (PP) in the early seventies, this surgical procedure has improved the lives of thousands of men, with reliable and satisfactory results. The aim of this review article is to characterize the epidemiology of men undergoing penile prosthetic surgery, with a discussion about the most common conditions involved in the development of ED, and that ultimately drive patients into electing to undergo PP placement.
Diabetes Complications/surgery* ; Diabetes Mellitus/epidemiology* ; Erectile Dysfunction/surgery* ; Humans ; Hypertension ; Impotence, Vasculogenic/surgery* ; Male ; Pelvic Bones/injuries* ; Penile Implantation/statistics & numerical data* ; Penile Induration/surgery* ; Penile Prosthesis ; Penis/injuries* ; Prostatectomy/adverse effects* ; Prostatic Neoplasms/surgery* ; Radiation Injuries/surgery* ; Radiotherapy/adverse effects* ; Reoperation ; Spinal Cord Injuries/epidemiology* ; Vascular Diseases/epidemiology* ; Wounds and Injuries/epidemiology*