Allen Morey and B. Cordon

Artificial Urinary Sphincter, High Submuscular, Stress Urinary Incontinence, Post-Prostatectomy Incontinence

Introduction: Demonstration of AUS placement with HSM PRB placement.

Case presentation: 74-year-old male with post-robotic prostatectomy incontinence.

Protocol: A perineal incision provides excellent exposure of the bulbar urethra for cuff placement. Through a separate high scrotal incision a retractor is placed within the superficial ring. Blunt finger dissection above the transversalis fascia develops a space below the rectus that accomodates the PRB which is easily placed in the high submuscular space without any additional instrumentation.

Outcome: There is no difference in revision rates between HSM versus Space of Retzius (SOR) placement. 

Discussion: HSM placement avoids potential complications of SOR and avoids intraperitoneal placement post-robotic prostatectomy.