Article Data

  • Views 1191
  • Dowloads 149

Systematic review

Open Access

Synchronous placement of penile prosthesis and artificial urinary sphincter: a systematic review with cumulative analysis

  • Shannon Jordan1
  • Jane Hendry1
  • Abdulla Al-Ansari2
  • Raidh Talib2
  • Aksam Yassin2,3
  • Omar M Aboumarzouk2,4,5

1Department of Urology, Queen Elizabeth University Hospital, G51 4TF Glasgow, UK

2Surgical Department, Hamad Medical Corporation, 4281 Doha, Qatar

3Department of Medicine and Health Sciences, Dresden International University, 01067 Dresden, Germany

4School of Medicine, Dentistry and Nursing, University of Glasgow, G12 8QQ Scotland, UK

5College of Medicine, Qatar University, 9FJR+4RC Doha, Qatar

DOI: 10.31083/jomh.2021.117 Vol.17,Issue 4,September 2021 pp.30-36

Submitted: 10 June 2021 Accepted: 02 August 2021

Published: 30 September 2021

*Corresponding Author(s): Shannon Jordan E-mail:

PDF (376.07 kB)


Radical prostatectomy is a life saving treatment for localised prostate cancer but may come with debilitating consequences, such as incontinence and erectile dysfunction. Penile Prosthesis Implants (PPI) are the gold standard of treatment for patients with refractory Erectile Dysfunction (ED) resistant to conservative management. Likewise, an Artificial Urinary Sphincter (AUS) is gold standard for those with refractory severe urinary incontinence. This systematic review with cumulative analysis assesses the efficacy and complications rates for synchronous placement of PPI and AUS as a single-stage procedure. Systematic literature review was performed using the US National Library of Medicine's life science database (MEDLINE) (2000 to May 2021), EMBASE (2000 to May 2021), Cochrane Central Register of Controlled Trials-CENTRAL (in the Cochrane Library-2021), Google Scholar and Individual journals. 5 studies were included for analysis, with total of 112 patients. The overall revision/replacement rate was 12.5% (n = 14). The revision rate for PPI alone was 4.5% (n = 5), for AUS was 6.5% (n = 9). The overall removal rate was 5.4% (n = 6). Removal rate for PPI alone was 0.9% (n = 1), for AUS was 1.4% (n = 3). There were only 2 case of dual prosthesis removal (1.4%). Our cumulative analysis has revealed that revision and removal rates for synchronous dual implants may be lower than previously believed. However, our review has highlighted the low quality of available data and stresses that more robust studies are required to validate the high satisfaction and low complication rates reported by small studies.


Penile prosthesis implants; Artificial urinary sphincters; Erectile dysfunction; Severe urinary incontinence

Cite and Share

Shannon Jordan,Jane Hendry,Abdulla Al-Ansari,Raidh Talib,Aksam Yassin,Omar M Aboumarzouk. Synchronous placement of penile prosthesis and artificial urinary sphincter: a systematic review with cumulative analysis. Journal of Men's Health. 2021. 17(4);30-36.


[1] Saleh A, Abboudi H, Ghazal-Aswad M, Mayer EK, Vale JA. Manage-ment of erectile dysfunction post-radical prostatectomy. Research and Reports in Urology. 2015; 7: 19–33.

[2] Singla N, Singla AK. Post-prostatectomy incontinence: Etiology, evaluation, and management. Turkish Journal of Urology. 2014; 40: 1–8.

[3] Wilson SK, Delk JR, Henry GD, Siegel AL. New Surgical Technique for Sphincter Urinary Control System Using Upper Transverse Scrotal Incision. Journal of Urology. 2003; 165: 261–264.

[4] Patel N, Golan R, Halpern JA, Sun T, Asafu-Adjei AD, Chughtai B, et al. A Contemporary Analysis of Dual Inflatable Penile Prosthesis and Artificial Urinary Sphincter Outcomes. Journal of Urology. 2019; 201: 141–146.

[5] Parulkar BG, Barrett DM. Combined implantation of artificial sphinc-ter and penile prosthesis. Journal of Urology. 1989; 142: 732–735.

[6] Boysen WR, Cohen AJ, Kuchta K, Park S, Milose J. Combined Place-ment of Artificial Urinary Sphincter and Inflatable Penile Prosthesis does not Increase Risk of Perioperative Complications or Impact Long-term Device Survival. Urology. 2019; 124: 264–270.

[7] Sellers CL, Morey AF, Jones LA. Cost and time benefits of dual implantation of inflatable penile and artificial urinary sphincter prosthetics by single incision. Urology. 2005; 65: 852–853.

[8] Kendirci M, Gupta S, Shaw K, Morey A, Jones L, Hakim L, et al. Synchronous prosthetic implantation through a transscrotal incision: an outcome analysis. Journal of Urology. 2006; 175: 2218–2222.

[9] Mancini JG, Kizer WS, Jones LA, Mora RV, Morey AF. Patient satisfaction after dual implantation of inflatable penile and artificial urinary sphincter prostheses. Urology. 2008; 71: 893–896.

[10] Bolat D, Kozacioglu Z, Polat S, Koras O, Arslan M, Minareci S. Synchronous penoscrotal implantation of penile and artificial urinary sphincter prosthesis after radical prostatectomy: Single institutional experience in 9 years. Archivos Españoles de Urología. 2017; 70: 367–372.

[11] Martínez-Salamanca JI, Espinós EL, Moncada I, Portillo LD, Car-ballido J. Management of end-stage erectile dysfunction and stress urinary incontinence after radical prostatectomy by simultaneous dual implantation using a single trans-scrotal incision: surgical technique and outcomes. Asian Journal of Andrology. 2015; 17: 792–796.

[12] Rolle L, Ceruti C, Sedigh O, Timpano M, Destefanis P, Lillaz B, et al. Surgical implantation of artificial urinary device and penile prosthesis through trans-scrotal incision for postprostatectomy urinary incontinence and erectile dysfunction: synchronous or delayed procedure?Urology. 2012; 80: 1046–1050.

[13] Lee D, Romero C, Alba F, Westney OL, Wang R. Simultaneous penile prosthesis and male sling/artificial urinary sphincter. Asian Journal of Andrology. 2012; 15: 10–15.

[14] Mirheydar H, Zhou T, Chang DC, Hsieh T. Reoperation Rates for Penile Prosthetic Surgery. Journal of Sexual Medicine. 2016; 13: 129–133.

[15] Grewal S, Vetter J, Brandes SB, Strope SA. A population-based analysis of contemporary rates of reoperation for penile prosthesis procedures. Urology. 2014; 84: 112–116.

[16] Lai HH, Hsu EI, Teh BS, Butler EB, Boone TB. 13 years of experience with artificial urinary sphincter implantation at Baylor College of Medicine. Journal of Urology. 2007; 177: 1021–1025.

[17] Tutolo M, Cornu J, Bauer RM, Ahyai S, Bozzini G, Heesakkers J, et al. Efficacy and safety of artificial urinary sphincter (AUS): Results of a large multi‐institutional cohort of patients with mid‐term follow‐up. Neurourology and Urodynamics. 2019; 38: 710–718.

[18] Graham SD, Carson CC, Anderson EE. Long-term results with the Kaufman prosthesis. Journal of Urology. 1982; 128: 328–330.

[19] Raj GV, Peterson AC, Toh KL, Webster GD. Outcomes following re-visions and secondary implantation of the artificial urinary sphincter. Journal of Urology. 2005; 173: 1242–1245.

[20] Ajay D, Mendez MH, Wang R, Westney OL. Treatment of Urinary Incontinence in Patients with Erectile Dysfunction. Sexual Medicine Reviews. 2020. (in press)

[21] Al-Shaiji TF. Dual implantation of artificial urinary sphincter and inflatable penile prostheses for concurrent male urinary incontinence and erectile dysfunction. Advances in Urology. 2011; 2011: 178312.

[22] Gon LM, de Campos CCC, Voris BRI, Passeri LA, Fregonesi A, Riccetto CLZ. A systematic review of penile prosthesis infection and meta-analysis of diabetes mellitus role. BMC Urology. 2021; 21: 35.

Abstracted / indexed in

Science Citation Index Expanded Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Social Sciences Citation Index Social Sciences Citation Index contains over 3,400 journals across 58 social sciences disciplines, as well as selected items from 3,500 of the world’s leading scientific and technical journals. More than 9.37 million records and 122 million cited references date back from 1900 to present.

Current Contents - Social & Behavioral Sciences Current Contents - Social & Behavioral Sciences provides easy access to complete tables of contents, abstracts, bibliographic information and all other significant items in recently published issues from over 1,000 leading journals in the social and behavioral sciences.

Current Contents - Clinical Medicine Current Contents - Clinical Medicine provides easy access to complete tables of contents, abstracts, bibliographic information and all other significant items in recently published issues from over 1,000 leading journals in clinical medicine.

SCOPUS Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

DOAJ DOAJ is a community-curated online directory that indexes and provides access to high quality, open access, peer-reviewed journals.

CrossRef Crossref makes research outputs easy to find, cite, link, assess, and reuse. Crossref committed to open scholarly infrastructure and collaboration, this is now announcing a very deliberate path.

Portico Portico is a community-supported preservation archive that safeguards access to e-journals, e-books, and digital collections. Our unique, trusted process ensures that the content we preserve will remain accessible and usable for researchers, scholars, and students in the future.

Submission Turnaround Time