Combined Inflatable Penile Prosthesis-Artificial Urinary Sphincter Implantation: No Increased Risk of Adverse Events Compared to Single or Staged Device Implantation

Segal, Robert; Cabrini, Marcelo R.; Harris, Elaine D.; Mostwin, Jacek L.; Bivalacqua, Trinity J.; Burnett, Arthur L.

doi:10.1016/j.juro.2013.06.084

Cited by 37 publications

(25 citation statements)

References 25 publications

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“…In severe forms of UI and ED, nonoperative treatment is inadequately effective and the standard of care consists in the surgical implantation of an artificial urinary sphincter and penile prosthesis , respectively. In patients with both disorders, the combined implantation of the two medical devices is feasible . However, the patient then has two pumps positioned in the scrotum, one to urinate and the other to induce erection.…”

Section: Introductionmentioning

confidence: 99%

Delivery of human mesenchymal adipose-derived stem cells restores multiple urological dysfunctions in a rat model mimicking radical prostatectomy damages through tissue-specific paracrine mechanisms

et al. 2015

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Urinary incontinence (UI) and erectile dysfunction (ED) are the most common functional urological disorders and the main sequels of radical prostatectomy (RP) for prostate cancer. Mesenchymal stem cell (MSC) therapy holds promise for repairing tissue damage due to RP. Because animal studies accurately replicating post-RP clinical UI and ED are lacking, little is known about the mechanisms underlying the urological benefits of MSC in this setting. To determine whether and by which mechanisms MSC can repair damages to both striated urethral sphincter (SUS) and penis in the same animal, we delivered human multipotent adipose stem cells, used as MSC model, in an immunocompetent rat model replicating post-RP UI and ED. In this model, we demonstrated by using noninvasive methods in the same animal from day 7 to day 90 post-RP injury that MSC administration into both the SUS and the penis significantly improved urinary continence and erectile function. The regenerative effects of MSC therapy were not due to transdifferentiation and robust engraftment at injection sites. Rather, our results suggest that MSC benefits in both target organs may involve a paracrine process with not only soluble factor release by the MSC but also activation of the recipient's secretome. These two effects of MSC varied across target tissues and damaged-cell types. In conclusion, our work provides new insights into the regenerative properties of MSC and supports the ability of MSC from a single source to repair multiple types of damage, such as those seen after RP, in the same individual. STEM CELLS 2016;34:392-404 SIGNIFICANCE STATEMENTRadical prostatectomy, the common treatment for localized prostate cancer, may lead to both urinary incontinence and erectile dysfunction. In this article, we found that mesenchymal stem cell-based therapies might be a promising approach to repair these two functional disorders in a paracrine and tissue specific fashion. In particular, our results strongly suggest that mesenchymal stem cells repair damaged striated urethral sphincter and penis not soleley by secreting paracrine factors but also by stimulating the host's secretome.

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Section: Introductionmentioning

confidence: 99%

Delivery of human mesenchymal adipose-derived stem cells restores multiple urological dysfunctions in a rat model mimicking radical prostatectomy damages through tissue-specific paracrine mechanisms

et al. 2015

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“…With regard to mean operative time, we found it longer in the PP+AUS group compared to the PP+MS (188.5±57.2 minutes vs. 157.5±48.7 minutes, p=0.085) but it was lacking statistical significance. For the PP+AUS group, operative time was in line with Segal et al [22] series on 55 patients (218.1 minutes). However in his study, operative time was significantly longer in the dual implantation group when compared to placement of PP and AUS alone (145.9 and 114.7 minutes, respectively, p<0.0001).…”

Section: Discussionmentioning

confidence: 57%

Concurrent Penile Prosthesis and Artificial Urinary SphincterversusPenile Prosthesis and Male Sling: A National Multi-Institutional Analysis of National Surgical Quality Improvement Program Database Comparing Postoperative Morbidity

Khalil

Bramwell

Bhandari

et al. 2021

World J Mens Health

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Purpose: We aimed to assess the 30-day morbidity in patients undergoing combined insertion of penile prosthesis (PP) and artificial urinary sphincter (AUS) vs. PP and male sling (MS). Materials and Methods: The National Surgical Quality Improvement Program database was queried to identify patients who underwent placement of AUS or MS combined with PP. Patient demographics, postoperative morbidity including complications, readmission and reoperation rates were recorded. Student t-test and chi-square or Fischer's exact test were used as appropriate. Results: Forty-one patients met selection criteria between 2010 and 2016. Overall, 26 patients received PP and AUS vs. 15 that received PP and MS. Average age was similar in both groups (64.8±6.6 years vs. 62.3±6.3 years, p=0.254). Diabetes mellitus was more prevalent in PP+MS group compared to AUS+PP group (46.7% vs. 11.5%, p=0.022). Average length of stay was higher in PP+AUS group compared to PP+MS group (2.2±0.6 days vs. 1.8±0.4 days, p=0.017). Postoperative morbidity was reported in four patients in PP+AUS group. No reported complications in PP+MS group. In PP+AUS group, complications included one patient who developed urinary tract infection, one developed surgical site infection, readmission in two for postoperative infection, and one return to the operating room. No reported prosthesis explantation or revision in either groups. Conclusions: Our results showed that 30-day morbidity was recorded in the PP+AUS group and none in the PP+MS group. The complication and readmission rates remain comparable to the previous reports in both groups.

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“…In experienced surgical hands, however, these procedures can be accomplished either in a staged fashion or simultaneously …”

Section: Resultsmentioning

confidence: 99%

Artificial Urinary Sphincter: Report of the 2015 Consensus Conference

Biardeau

Aharony

Campeau

et al. 2016

Neurourology and Urodynamics

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Combined Inflatable Penile Prosthesis-Artificial Urinary Sphincter Implantation: No Increased Risk of Adverse Events Compared to Single or Staged Device Implantation

Cited by 37 publications

References 25 publications

Delivery of human mesenchymal adipose-derived stem cells restores multiple urological dysfunctions in a rat model mimicking radical prostatectomy damages through tissue-specific paracrine mechanisms

Delivery of human mesenchymal adipose-derived stem cells restores multiple urological dysfunctions in a rat model mimicking radical prostatectomy damages through tissue-specific paracrine mechanisms

Concurrent Penile Prosthesis and Artificial Urinary SphincterversusPenile Prosthesis and Male Sling: A National Multi-Institutional Analysis of National Surgical Quality Improvement Program Database Comparing Postoperative Morbidity

Artificial Urinary Sphincter: Report of the 2015 Consensus Conference

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