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Outcomes following erosions of the artificial urinary sphincter.

Publication ,  Journal Article
Raj, GV; Peterson, AC; Webster, GD
Published in: J Urol
June 2006

PURPOSE: Artificial urinary sphincter urethral cuff erosion occurs in up to 5.0% of cases, presenting a complex management problem. We examine our experience with the eroded AUS, relating to preoperative risk factors, operative management and outcomes. MATERIALS AND METHODS: We reviewed the medical records of 637 patients undergoing bulbar urethral AUS implantation from 1990 to 2003 for demographic and surgical variables. RESULTS: Of the 637 records reviewed, 46 patients underwent 54 explantations of the AUS device for erosions, including 13 who had the primary implant performed at our institution and 33 being referred for management of erosion after implantation elsewhere. Our institution erosion rate was 2.2%. Mean followup after AUS reimplant following erosion was 27.8 months (range 1 to 180). Comorbidities were more prevalent in patients with erosions included hypertension (p = 0.006), coronary artery disease (p = 0.03), prior radiation therapy (p = 0.006) and prior AUS revisions (p = 0.0001). A majority of patients had persistent mild incontinence (0 to 1 pad daily in 29 or 56.8%), moderate (1 to 3 pads daily in 9 or 17.4%) and severe (more than 3 pads daily in 6 or 11.8%) incontinence after secondary AUS implantation. Patients who underwent reimplantation after AUS cuff erosions have a significantly higher rate of second erosions (in 16, 34.8%) within an average of 6.7 months (range 3 to 24), including our own 11.8% institutional rate (in 4). CONCLUSIONS: Our study suggests that patients with comorbidities including hypertension, coronary artery disease, prior radiation therapy and prior AUS revisions are more likely to have erosions of their AUS. Nevertheless, continence can still be salvaged using various strategies which optimize use of the remaining healthy urethral tissue.

Duke Scholars

Published In

J Urol

DOI

ISSN

0022-5347

Publication Date

June 2006

Volume

175

Issue

6

Start / End Page

2186 / 2190

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Urinary Sphincter, Artificial
  • Urinary Incontinence
  • Treatment Outcome
  • Risk Factors
  • Reoperation
  • Prosthesis Failure
  • Humans
  • Follow-Up Studies
  • Device Removal
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Raj, G. V., Peterson, A. C., & Webster, G. D. (2006). Outcomes following erosions of the artificial urinary sphincter. J Urol, 175(6), 2186–2190. https://doi.org/10.1016/S0022-5347(06)00307-7
Raj, Ganesh V., Andrew C. Peterson, and George D. Webster. “Outcomes following erosions of the artificial urinary sphincter.J Urol 175, no. 6 (June 2006): 2186–90. https://doi.org/10.1016/S0022-5347(06)00307-7.
Raj GV, Peterson AC, Webster GD. Outcomes following erosions of the artificial urinary sphincter. J Urol. 2006 Jun;175(6):2186–90.
Raj, Ganesh V., et al. “Outcomes following erosions of the artificial urinary sphincter.J Urol, vol. 175, no. 6, June 2006, pp. 2186–90. Pubmed, doi:10.1016/S0022-5347(06)00307-7.
Raj GV, Peterson AC, Webster GD. Outcomes following erosions of the artificial urinary sphincter. J Urol. 2006 Jun;175(6):2186–2190.
Journal cover image

Published In

J Urol

DOI

ISSN

0022-5347

Publication Date

June 2006

Volume

175

Issue

6

Start / End Page

2186 / 2190

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Urinary Sphincter, Artificial
  • Urinary Incontinence
  • Treatment Outcome
  • Risk Factors
  • Reoperation
  • Prosthesis Failure
  • Humans
  • Follow-Up Studies
  • Device Removal