Artificial urinary sphincter (AUS) insertion remains the standard of care for fit patients with stress urinary incontinence (SUI) following a radical prostatectomy (RP). Previous failed AUS, urethroplasty, or pelvic radiotherapy can compromise urethral tissue. The transcorporal cuff (TC) placement has been described to facilitate continence in these men, but the traditional approach may be complicated by a haematoma. This narrated video demonstrates the tunical flap (TF) modification for transcorporal AUS Implantation via a perineal and penoscrotal approach in patients with prior failed AUS placements secondary to urethral erosion.

In this narrated video, two patients underwent the TF modification for TC AUS implantation via the perineal and penoscrotal approaches in patients with prior failed AUS placements.

The TF modification enabled successful AUS placement with circumferential reinforcement from the tunica albuginea from the corpora cavernosa. In our early results, there has been no post-operative haematoma formation with this technique

The TF modification for transcorporal AUS implantation is a safe and effective approach for men with compromised urethral tissue. The TF preserves corporal volume and does not limit candidacy for future penile prothesis implantation. Long-term follow-up is necessary to assess long-term durability of this technique.