PURPOSE: While the AMS 800 artificial urinary sphincter improves continence in up to 90% of patients, revision surgery may be needed in up to 50% of patients.
We sought to determine if an ohmmeter can accurately assess the site of fluid leak from individual components of the AUS at the time of revision surgery.
MATERIALS AND METHODS: We conducted a retrospective review of patients undergoing AUS revision surgery between 1996 and 2013. Patients who had fluid loss identified preoperatively by the use of plain film radiography and subsequently underwent revision surgery with use of the ohmmeter were assessed for outcomes.
RESULTS: Intraoperative ohmmeter usage was performed in 20 surgical cases on 19 patients and correctly identified the location of fluid loss in 18/20 cases (90%). Fluid leakage was found from the PRB in 13 cases, the cuff in 4, and tubing to the PRB in 1 case. None had fluid loss from the pump. In the 17 cases where a patient underwent replacement of only the malfunctioning component, a satisfactory postoperative outcome with a fully functional device was documented in all. Repeat surgery was performed in 5/17 (29.4%) cases at a median of 17 months (range 2 to 39). No patient had repeat surgery due to failure to accurately diagnose component leak.
CONCLUSIONS: In cases of suspected fluid loss as a cause of AUS malfunction, an ohmmeter can identify the site of fluid loss during component revision surgery.
Written by:
Selph JP, Belsante MJ, Gupta S, Ajay D, Lentz A, Webster G, Le NB, Peterson AC. Are you the author?
Duke University Medical Center, Division of Urology, Division of Reconstructive Urology, Durham, NC; University of Kentucky, Department of Urology, Lexington, KY.
Reference: J Urol. 2015 May 16. pii: S0022-5347(15)04013-6.
doi: 10.1016/j.juro.2015.05.075
PubMed Abstract
PMID: 25988517