Surgical Replacement of AUS and Malleable Penile Implant via the Penoscrotal Approach

R. Rowaiee, A. Al Homsi, O. Almidani, O. A Raheem

Artificial urinary sphincter, Malleable penile implant, Penoscrotal approach, Prosthetic revision surgery, Urinary incontinence surgery, Penile prosthesis

This surgical video illustrates the simultaneous replacement of an artificial urinary sphincter (AUS) and malleable penile implant through a single penoscrotal incision. The presentation details exposure techniques, device explantation, and reimplantation steps, emphasizing anatomical orientation and preservation of existing tissue planes. Key procedural points include cuff and reservoir placement, avoidance of cross-contamination between prosthetic fields, and secure device positioning for optimal functional outcomes. The approach enables efficient dual prosthetic revision with minimized morbidity and excellent cosmesis, offering a practical guide for experienced reconstructive urologists.

None. 

None. 

1. Scott FB, Bradley WE, Timm GW. Treatment of urinary incontinence by implantable prosthetic sphincter. Urology. 1973;1(3):252–259.

2. Wilson SK, Delk JR. Inflatable penile implant infection: predisposing factors and treatment suggestions. J Urol. 1995;153(3):659–661.

3. Linder BJ, Elliott DS. Artificial urinary sphincter revision and replacement: contemporary outcomes. J Urol. 2016;195(4):1038–1043.

4. Henry GD, Wilson SK. Updates in penile prosthesis surgery. Curr Urol Rep. 2011;12(6):466–471.

5. Trost LW, Elliott DS. Penile prosthesis revision surgery: technical considerations and outcomes. Transl Androl Urol. 2017;6(Suppl 5):S869–S878.