PURPOSE: This study compares stricture outcomes of artificial urinary sphincter (AUS) cuff erosion patients managed with and without synchronous urethral repair.
MATERIALS AND METHODS: Patients undergoing AUS removal for cuff erosion from 2007-2013 were retrospectively reviewed. Two cohorts of patients were evaluated - group 1 patients underwent in-situ urethroplasty (ISU) while those in group 2 were treated with a Foley catheter only (FCO). We compared demographic, clinical, and radiologic data to assess resultant stricture disease between both cohorts, as well as operative times.
RESULTS: Of the 26 AUS cuff erosion cases identified, 13 patients underwent ISU while 13 did not. The mean age was 73 (range 61-83) years, with a mean follow-up of 24 months (8 - 69). The rate of urethral stricture formation after AUS explantation was significantly reduced among ISU patients (5/13; 38%) compared to FCO patients (11/13; 85%, p=0.047). Mean operative times were similar: 78 min (50-133) for the ISU group versus 70 min (51-92) for the FCO group (p=0.39). ISU patients underwent significantly fewer procedures per patient prior to AUS replacement (0.4 versus 1.1, p=0.004) and had a much higher rate of eventually receiving secondary AUS implantation (7/13, 54% versus 2/13, 15%, p=0.04) compared to cuff erosion patients treated with Foley catheter only.
CONCLUSION: Urethral repair at the time of AUS explantation for cuff erosion appears to prevent stricture development, thus facilitating successful AUS replacement.
Written by:
Rozanski AT, Tausch TJ, Ramirez D, Simhan J, Scott JF, Morey AF. Are you the author?
Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX.
Reference: J Urol. 2014 Feb 7. pii: S0022-5347(14)00256-0.
doi: 10.1016/j.juro.2014.02.007
PubMed Abstract
PMID: 24512955
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