(336) A NOVEL TECHNIQUE OF CORPORAL REPAIR DURING TRANS CORPORAL ARTIFICIAL URINARY SPHINCTER CUFF PLACEMENT WITH AN INFLATABLE PENILE PROSTHESIS IN PLACE USING ALLOGENIC PERICARDIAL GRAFT (TUTOPLAST®)

Abstract Introduction The number of patients with post prostatectomy stress urinary incontinence (SUI) and erectile dysfunction (ED) is growing. And the use Artificial urinary sphincter (AUS) and inflatable penile prosthesis (IPP) in the management of such conditions has proven its efficacy, especially for the refractory cases. Many patients have both devices, and since the AUS revision rates are higher, some will need further AUS procedures with their IPP in place. This might constitute a challenge that require special consideration. Objective We review a new technique for corporal repair using allogenic pericardial graft (Tutoplast®) in patients undergoing AUS revision procedure with trans corporal (TC) AUS cuff placement while an IPP cylinders are in situ. The intent is to achieve intra op hemostasis after corporal violation and to separate and protect the IPP cylinders and AUS cuff from direct contact and frication, thus decreasing the risk of long term mechanical failure. Methods We report a new technique of corporal repair during TC AUS revision procedure with in situ IPP. The technique has been done for two patients so far. In both patients a 3 cm bilateral corporotomies were done to create a corporal flap on the dorsal side of the urethra for the new cuff TC placement. Then a Tutoplast graft of a proper size was sutured to the lateral edges of corporotomies to isolate the IPP in situ cylinders from the planned new TC cuff (fig. 1). Next, the AUS cuff was placed between the graft and the corporal flap/urethra followed by the placement of other AUS component. Results No early post-operative complications noted. Patients presented for AUS activation six weeks following the surgery. Functions of both AUS and IPP were confirmed during the visit and patients were instructed to use both devices. During the three and six months post-operative visits both patients were completely continent and were using the IPPs without any issues or complains. Conclusions A preliminary data supports the safety and short-term efficacy of using allogenic pericardial graft (Tutoplast®) in corporal repair for patients undergoing TC AUS cuff placement with an IPP cylinders in place. The technique might protect both the functioning IPP and the new AUS cuff and decrease the mechanical failure with ideal hemostasis during the surgery. Further studies on larger populations are needed to support the long-term efficacy of this technique. Disclosure No.