Simultaneous implantation of an inflatable penile prosthesis and an artificial urinary sphincter

Erectile dysfunction and stress urinary incontinence are common complaints after radical prostatectomy, and can have profound effects on patient outcomes and postoperative quality of life. Both problems can be surgically managed with implantation of prosthetic devices. To treat erectile dysfunction, patients can be offered a penile prosthesis, and the gold standard for moderate-to-severe urinary leakage is the artificial urinary sphincter. Despite the success of these therapies, their simultaneous implantation is uncommon despite evidence suggesting that the practice is safe and efficacious. We provide step-by-step instructions, with video support, on how to perform a single-incision dual implantation. Attention is set to identify and prevent common complications of this procedure. When done correctly, the simultaneous placement of both devices has been shown to have similar infectious and mechanical complication rates while minimizing anesthetic exposure. A trained urologist should feel comfortable offering dual implantation to properly selected patients.