Concomitant Treatment of Erectile Dysfunction and Postprostatectomy Stress Urinary Incontinence (CME)

Abstract

A66‐year‐old man presented to our clinic for the treatment of persistent postprostatectomy stress urinary incontinence (SUI). He had undergone a robotic‐assisted radical prostatectomy 15 months previously for Gleason's grade 6/10 prostate adenocarcinoma. At the time of prostatectomy, his prostate specific antigen (PSA) was 4.6. The PSA had remained undetectable since surgery, and the patient had required no adjuvant treatment for his malignancy. However, SUI had not resolved with the patient reporting the use of 2–3 protective pads per day. In fact, since 10 months postsurgery the degree of the incontinence had not significantly improved despite conservative measures. Query as to the patient's erectile function status revealed that he had used phosphodiesterase type 5 inhibitors prior to the prostatectomy with moderate success. Since surgery, oral therapy was ineffective. Penile injection therapy had been attempted but was felt to be inconvenient by the patient and his partner. The use of a vacuum erection device provided an erection that the patient felt was inadequate for sexual intercourse.