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