Penile implants increase the risk of device erosion of artificial urinary sphincters

This study examined the effects of penile implants among men already treated with artificial urinary sphincters. Authors reported an increased risk of device erosion and removal among men treated with both surgical procedures compared to those with artificial urinary sphincters only.

A common side effect of prostate surgery is erectile dysfunction. Men with severe erectile dysfunction may undergo the placement of a penile implant. This involves the surgical placement of a prosthetic device into the penis to enable penetrative sexual activity.

Prostate surgery can also damage the urethral sphincter, the muscles that control the exit of urine. The surgical placement of an artificial urinary sphincter can help restore urinary continence after prostate surgery. The artificial sphincter includes an inflatable cuff that fits around the bladder base.

Since erectile dysfunction and urinary incontinence are both common side effects of prostate surgery, some men may be treated with both a penile implant and an artificial urinary sphincter. Whether this affects their safety or effectiveness is still being investigated.

The aim of this study was to examine outcomes of artificial urinary sphincters in men with and without penile prosthetics.

366 men treated with artificial urinary sphincters were included. Of these, 32.2% of men later received a penile implant. Their effects on artificial urinary sphincters were examined over an average period of 41 months.

Erosion of the cuff was significantly more common among men treated with both surgical procedures. It was 11.6% for men treated with both procedures and 4.3% for men treated with an artificial urinary sphincter only. The artificial urinary sphincter device had to be removed in 17% of men treated with both procedures. This was significantly higher compared to men treated with an artificial urinary sphincter only (9.2%). The type of penile prosthetic or artificial urinary sphincter device did not appear to affect this result.

Authors concluded that patients treated with both an artificial urinary sphincter and a penile implant are at higher risk of cuff erosion and device removal.