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A Contemporary Analysis of Dual Inflatable Penile Prosthesis and Artificial Urinary Sphincter Outcomes.

TitleA Contemporary Analysis of Dual Inflatable Penile Prosthesis and Artificial Urinary Sphincter Outcomes.
Publication TypeJournal Article
Year of Publication2019
AuthorsPatel N, Golan R, Halpern JA, Sun T, Asafu-Adjei ADenise, Chughtai B, Stahl P, Sedrakyan A, Kashanian JA
JournalJ Urol
Volume201
Issue1
Pagination141-146
Date Published2019 01
ISSN1527-3792
KeywordsAged, Erectile Dysfunction, Humans, Male, Middle Aged, New York, Penile Implantation, Penile Prosthesis, Prosthesis Design, Reoperation, Retrospective Studies, Time Factors, Treatment Outcome, Urinary Incontinence, Stress, Urinary Sphincter, Artificial
Abstract

PURPOSE: Inflatable penile prostheses and artificial urinary sphincters are used to treat men with erectile dysfunction and stress urinary incontinence, respectively. After prostate cancer treatment men often experience erectile dysfunction and stress urinary incontinence. Dual prosthetic implantation can improve the quality of life of these men. We evaluated reoperation outcomes in men who underwent dual implantation compared to each device implanted individually.

MATERIALS AND METHODS: We queried the SPARCS (New York State Department of Health Statewide Planning and Research Cooperative) database for men who underwent inflatable penile prosthesis and/or artificial urinary sphincter insertion between 2000 and 2014. The primary outcomes were the inflatable penile prosthesis and artificial urinary sphincter reoperation 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.

RESULTS: Median followup in the inflatable penile prosthesis cohort was 66 months (IQR 25-118) and in the artificial urinary sphincter cohort it was 69 months (IQR 27-121). Compared with men who received a penile prosthesis alone those with a penile prosthesis and an artificial urinary sphincter had a higher likelihood of undergoing inflatable penile prosthesis reoperation at 1 year (OR 2.08, 95% CI 1.32-3.27, p <0.01) and 3 years (OR 2.60, 95% CI 1.69-3.99, p <0.01). Compared with an artificial urinary sphincter alone patients with an inflatable penile prosthesis and an artificial urinary sphincter did not have a higher likelihood of undergoing artificial urinary sphincter reoperation at 1 year (p = 0.76) or 3 years (p = 0.73).

CONCLUSIONS: Combined inflatable penile prosthesis and artificial urinary sphincter insertion portends a higher likelihood of inflatable penile prosthesis reoperation at 1 and 3 years. However, artificial urinary sphincter outcomes remain comparable. These findings should be used to better counsel patients about the risk of reoperation when undergoing dual implantation.

DOI10.1016/j.juro.2018.07.046
Alternate JournalJ. Urol.
PubMed ID30059687
Grant ListU01 FD005478 / FD / FDA HHS / United States
Division: 
Comparative Effectiveness & Outcomes Research
Category: 
Faculty Publication