Complication Rates in Concurrent Inflatable Penile Prosthesis and Incontinence Surgery: Comparing the Penoscrotal Versus Perineal Incision Approach

Abstract Introduction: Limited data exist on inflatable penile prosthesis (IPP) complication rates following dual implantation with an artificial urinary sphincter (AUS) or bulbourethral male sling via a single perineal incision. Herein, we assess IPP complication rates after dual implantation via a single perineal incision versus more traditional penoscrotal approach. Methods: Patients with dual implantations of an IPP and AUS or sling between the 2011-2021 were identified. Postoperative IPP complications were assessed using the Clavien-Dindo (CD) classification at 6 months. Treatment satisfaction was assessed using the validated EDITS questionnaire. IPP complication rates and mean EDITS scores were compared between the perineal and penoscrotal groups. Results: A total of 38 patients underwent dual implantation; 24 perineal vs 14 penoscrotal. There was no statistical difference in rate of complications between the two groups. The penoscrotal group had only two CD Grade I complications reported in the 30-day period and one Grade III complication in the >30 day to 6-month postoperative period. The perineal group had only two Grade III reported complications in the >6 month time frame. One patient in the perineal group and two in the penoscrotal group reported device malfunction at any point during follow-up, with no statistical difference in the rate of device malfunction. Conclusion: Patients undergoing dual IPP and AUS/sling placement via a perineal vs penoscrotal incision had similar IPP complication rates. A single perineal incision is a viable surgical approach for the dual implantation of an IPP and AUS or bulbourethral male sling.