Alternative Method of Securing a Mini-Jupette Sling

In this video we present our technique for mini jupette sling (MJS) placement during the placement of an inflatable penile prosthesis (IPP). MJS could be considered in patients who are experiencing incontinence or climacturia, common complications of radical prostatectomy and prostate cancer treatment. The technique is initially described by Dr Andrianne, and our technique is modified from the mini-jupette as employed by Dr Yafi. The standard dissection and exposure is done using a typical penoscrotal or subcoronal approach. The corporotomies and dilation are done in the typical fashion. However, instead of placing stay sutures on either side of the corporotomies, we only place them on the lateral sides. When the mini jupette is placed it is secured with a running suture, and a loop is tied in the middle and divided to create four free ends, after the start and end of the running suture are completed. These four free ends match up with the four stay sutures placed lateral to the corporotomies. The pairs are tied together once the cylinders are placed, closing the corporotomies and securing the mini-jupette at the same time. The corporotomies are eventually closed by tying the stay sutures across the incision. This technique allows for a secure sling placement, without bunching of the sling. Since the corporotomies can be tied closed, there is no risk of needle injury to the cylinders. Operative time is not significantly increased when adding this procedure. We have encountered no complications related to the mini-jupette with this method.