Lateral Thinking: The Carrion Modified Mini Jupette Sling For Dynamic Compression in Climacturia and Mild SUI

Guan, H, A. Falasiri, S, S, Fernandez-Crespo R, Parker, J, E. Carrion R

mini Jupette; inflatable penile prosthesis; climacturia; stress urinary incontinence; urethral sling

This narrated operative video shows every step of the Carrion modified mini-Jupette procedure, a single-stage solution for men who have erectile dysfunction plus climacturia or mild stress urinary incontinence (SUI) after prostate surgery. Through a midline penoscrotal incision, four 2-0 Ethibond sutures are placed in an outside-in and inside-out at the lateral corners of each corporotomy. Anchoring the mesh laterally—rather than medially or proximally—preserves corporotomy integrity, avoids device interference, and allows full cylinder expansion to create dynamic urethral compression. A 16 Fr Foley catheter and a 60 cm water-based retrograde leak point pressure (“drip”) test are used to aid in sling tensioning. The inflatable penile prosthesis (IPP) is inflated to approximately 80–100% in patients with climacturia alone, or as low as 30% for those with added SUI. Our current cohort includes 43 patients, and early outcomes have been favorable, with no major adverse events reported to date. Ongoing prospective data collection aims to assess long-term efficacy and guide refinements in patient selection. This video features close-up surgical footage demonstrating this novel modification to the mini Jupette procedure and serves as a comprehensive, step-by-step guide. This technique is safe, efficient, and readily adoptable by prosthetic surgeons.

None. 

Dr. Carrion is a a consultant for Coloplast, Boston Scientific, and RigiCon.

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