AMS-800 and AMS-700 combined implant

Steps in the procedure:

• 1. 16 Ch catheter Foley
• 2. Penoscrotal transverse incision
• 3. Isolation urethra with Babcock
• 4. Dissection peri-bulbar urethra
• 5. Measurement cuff length: 4 cm
• 6. Reservoir placement preparation right inguinal region (high submuscular) for penile implant; stay suture fascia musculus obliquus externus; cloverleaf reservoir filled with 100 cc
• 7. Reservoir placement left paravessical space for AUS; PRB; 25 cc; stay suture fascia musculus obliquus externus
• 8. Bilateral corporotomies with "W" stay sutures
• 9. Furlow length measurement: bilateral 5 cm proximal and 13 cm distal
• 10. Implantation cylinders LGX 18 cm bilateral
• 11. Placement of pumps in separate scrotal pouches; connection of all tubing
• 12. Foley catheter 12 Ch after AUS de-activation
• 13. Closure

Learning points:

• Well-trained team
• Do both implants mixed and not the one after the other
• A quick surgery is important

Clinical case:

• 68 yr. old male patient
• Erectile dysfunction > 15 yrs
• Non-responder to PDE-5 inhibitors and intra cavernous injections.
• Stress incontinence > 300 cc per day

Clinical history:

• 2009 bilateral hernia repair (Stoppa)
• 2010 Nesbitt with circumcision
• 2017 Robot Assisted Radical Prostatectomy; pT3ac G3 N0 M0; iPSA 5,4 mcg/l; Gleason 7