Radiation therapy following radical prostatectomy increases the risk of urethral atrophy and erosion during AUS placement. The transcorporeal technique offers a safer alternative for cuff placement in patients with fibrotic or fragile urethral tissue. This video demonstrates the transcorporeal approach in a patient with prior radiation therapy.

A patient with SUI post-radical prostatectomy and adjuvant pelvic radiation was selected for transcorporeal AUS insertion. The surgery was performed through a perineal incision. The tunica albuginea of the corpora cavernosa was incised bilaterally to create a tunnel through which the urethra was encased, adding a protective layer around the cuff.

The transcorporeal approach was successfully performed, providing enhanced tissue support around the urethra. No intraoperative or early postoperative complications occurred. The cuff was positioned securely without evidence of urethral injury. At 6-week follow-up, the device was activated and the patient reported improved continence with no signs of erosion or infection.

The transcorporeal technique is a valuable modification for AUS placement in irradiated patients, reducing the risk of erosion in compromised tissue. This video outlines the critical steps and technical nuances to safely perform this advanced approach.