(403) Artificial Urinary Sphincter Implantation for Severe Post-Prostatectomy Incontinence in Setting of Salvage Radiotherapy and Prior Inflatable Penile Prosthesis

Abstract Introduction Artificial urinary sphincter (AUS) implantation is one of the most common treatment options for individuals with severe stress incontinence (SUI), which a complication after radical prostatectomy (RP). The modern AUS consists urethral cuff, pump, and reservoir, serves as replacement native incompetent sphincter. There are various surgical approaches insertion, including transperineal, transscrotal, abdominal approaches. Objective This video covers technique an management SUI. Notably, this patient underwent RP followed by salvage radiotherapy (XRT) biochemical recurrence prostate cancer had prior inflatable penile prosthesis (IPP) placement. Methods A standard step-by-step placement through perineal incision additional counter to allow high submuscular pressure-regulating balloon demonstrated in unique case IPP XRT. Results We highlight meticulous dissection around urethra that challenging secondary proximal corpora. pump was successfully placed subdartos pouch scrotum on contralateral side avoid patient’s pump. At conclusion, flexible cystourethroscopy showed adequate cuff coaptation cycling. Conclusions insertion transperineal approach context Preoperative counseling, evaluation, careful intraoperative key parts procedure critical successful AUS, especially patients who at high-risk complications, such case. Disclosure No