PURPOSE: We analyzed our initial 100-case experience using the 3.5 cm artificial urinary sphincter (AUS) cuff to identify risk factors for cuff erosion.
MATERIALS AND METHODS: A single-surgeon consecutive series of patients undergoing 3.5 cm AUS cuff placement from September 2009 to August 2013 was reviewed. Each patient had a single perineal cuff placement via standardized technique. Preoperative characteristics, technical considerations, and postoperative outcomes were analyzed and compared to a cohort of patients undergoing larger (4.0 cm or greater) AUS cuff placement over the same time period. Clinical factors associated with an increased risk of 3.5 cm AUS cuff erosion were identified.
RESULTS: Of 176 men who met study inclusion criteria during the four-year study period, 100 (100/176, 57%) received the 3.5 cm AUS cuff, while 76 (76/176, 43%) received a larger (4.0 cm or greater) cuff: continence rates (83% vs. 80%, p=0.65) and mean follow-up duration (32 vs. 25 mo., p=0.14) were similar between the two groups. Erosions occurred in 16/176 (9%) overall during the study period with 13 among the 100 men having 3.5 cm cuffs. Most 3.5 cm cuff patients had a history of radiation (52/100, 52%) with erosion occurring in 11/52 (21%); cuff erosion occurred rarely in non-radiated men (2/48, 4%, p=0.01). History of radiation was the only significant risk factor associated with 3.5 cm cuff erosion (OR 6.2, CI [1.3-29.5]).
CONCLUSIONS: Men with a history of radiation who undergo placement of a 3.5 cm AUS cuff experience an elevated risk of cuff erosion (21%).
Written by:
Simhan J, Morey AF, Singla N, Tausch TJ, Scott JF, Lemack GE, Roehrborn CG. Are you the author?
Department of Urology, UT Southwestern Medical Center, Dallas, TX 75390-9110.
Reference: J Urol. 2014 Aug 5. pii: S0022-5347(14)04157-3.
doi: 10.1016/j.juro.2014.07.115
PubMed Abstract
PMID: 25106901
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