Patients with post-prostatectomy erectile dysfunction (ED) and stress urinary incontinence (SUI) may benefit from simultaneous placement of an inflatable penile prosthesis (IPP) and artificial urinary sphincter (AUS). The penoscrotal approach enables single-incision dual implantation. This video demonstrates the technique in a patient suffering from both conditions.

A patient with persistent SUI and ED following radical prostatectomy underwent simultaneous AUS and IPP placement via a penoscrotal incision. After corporal dilation and placement of IPP cylinders, attention was turned to cuff placement on the bulbar urethra, followed by positioning of the AUS pump and pressure-regulating balloon. A single scrotal incision provided access to all components.

Both devices were implanted successfully without complications. The use of a single incision reduced operative time and patient morbidity. Postoperative recovery was uneventful. The IPP was activated at 4 weeks, and the AUS at 6 weeks, with satisfactory function reported for both. The patient expressed high satisfaction with restored sexual and urinary function.

Simultaneous AUS and IPP insertion via a penoscrotal approach is safe, efficient, and effective in patients with dual dysfunction. This video highlights the technical strategy and surgical steps needed for successful combined prosthetic implantation through a single incision.