Inflatable Penile Prosthesis and Mini-Jupette Sling for Treating Climacturia in Men with Erectile Dysfunction

Abstract

Background: Climacturia and arousal incontinence commonly present substantial challenges to patients' quality of life after pelvic surgeries. When accompanied by erectile dysfunction (ED), the concomitant implantation of an inflatable penile prosthesis (IPP) and Mini-Jupette sling emerged as a promising option to simultaneously address both sexual function and continence. Therefore, our study aimed to assess efficacy and patient satisfaction of combined IPP and Mini-Jupette sling for treating climacturia and concurrent ED in post-pelvic procedure patients.

Methods: We retrospectively analyzed charts of men with concomitant ED and climacturia who underwent simultaneous IPP and Mini-Jupette sling placement from December 2022 to May 2025. Key endpoints included climacturia and continence status, residual leakage pattern, and subjective patient satisfaction.

Results: Preoperatively, all 29 patients presented with climacturia, 11 reported arousal incontinence, and 24 had stress urinary incontinence. At a mean follow-up of 9 months, 26 patients reported resolved climacturia, and 14 patients had complete continence. The average number of pads used per day reduced from 2.2 to 0.9. Among men with persistent leakage, 53% achieved a clinically meaningful improvement in leakage pattern. Overall, 72% of patients reported satisfaction with their outcomes. Of those not fully satisfied, 37% nonetheless experienced a clinical improvement in leakage pattern.

Conclusion: In our cohort, simultaneous IPP and Mini-Jupette sling placement proved to be a safe and streamlined approach, delivering marked improvement in climacturia and high satisfaction rates among men with ED and climacturia after pelvic surgery. While not specifically intended for incontinence, the Mini-Jupette sling also improved continence in select cases.