Combination surgery for erectile dysfunction and male incontinence

With favorable prognosis, radical therapy for pelvic malignancy no longer is just about oncological control, but is important in achieving the trifecta of oncological clearance with acceptable sexual function and urinary outcomes. As we face the prospect of escalating urogenital dysfunction following our radical interventions, we need to carefully assess these functional outcomes and their impact on the quality of life of our patients. In men, this includes urinary impairments with stress urinary incontinence, various types of voiding dysfunction, and sexual impairments (primarily erectile dysfunction and orgasmic dysfunction). Based on appropriate clinical and diagnostic assessments of severity of adverse outcomes depending on patient preference, combination surgery for treatment of erectile dysfunction and stress urinary incontinence is effective and durable and has an established, definitive role to address this not uncommon problem. This article reviews the prevalence of the problem, the available therapeutic options, and evidence of efficacy of these therapies in combination.