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3.5 cm Artificial Urinary Sphincter Cuff Erosion Occurs Predominantly in Irradiated Patients

2014; Lippincott Williams & Wilkins; Volume: 193; Issue: 2 Linguagem: Inglês

10.1016/j.juro.2014.07.115

1527-3792

Jay Simhan, Allen F. Morey, Nirmish Singla, Timothy J. Tausch, J. Francis Scott, Gary E. Lemack, Claus G. Roehrborn,

Pelvic floor disorders treatments

No AccessJournal of UrologyAdult Urology1 Feb 20153.5 cm Artificial Urinary Sphincter Cuff Erosion Occurs Predominantly in Irradiated Patients Jay Simhan, Allen F. Morey, Nirmish Singla, Timothy J. Tausch, J. Francis Scott, Gary E. Lemack, and Claus G. Roehrborn Jay SimhanJay Simhan , Allen F. MoreyAllen F. Morey , Nirmish SinglaNirmish Singla , Timothy J. TauschTimothy J. Tausch , J. Francis ScottJ. Francis Scott , Gary E. LemackGary E. Lemack , and Claus G. RoehrbornClaus G. Roehrborn View All Author Informationhttps://doi.org/10.1016/j.juro.2014.07.115AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We analyzed our initial 100-case experience with the 3.5 cm artificial urinary sphincter cuff to identify risk factors for cuff erosion. Materials and Methods: We reviewed the records of a single surgeon, consecutive series of patients treated with 3.5 cm artificial urinary sphincter cuff placement from September 2009 to August 2013. Each patient underwent single perineal cuff placement via standardized technique. Preoperative characteristics, technical considerations and postoperative outcomes were analyzed and compared to those in a cohort of patients in whom a larger (4.0 cm or greater) artificial urinary sphincter cuff was placed during the same period. We identified clinical factors associated with an increased risk of 3.5 cm artificial urinary sphincter cuff erosion. Results: Of the 176 men who met study inclusion criteria during the 4-year period 100 (57%) received the 3.5 cm artificial urinary sphincter cuff and 76 (43%) received a larger cuff (4.0 cm or greater). The continence rate (83% vs 80%, p = 0.65) and mean followup (32 vs 25 months, p = 0.14) were similar in the 2 groups. Erosion developed in 16 of the 176 patients (9%) during the study period, of whom 13 had the 3.5 cm cuff. Of the 100 patients with the 3.5 cm cuff 52 (52%) had a history of radiation, including 11 (21%) with erosion. Cuff erosion developed only rarely in nonirradiated men (2 of 48 or 4%, p = 0.01). A history of radiation was the only significant risk factor associated with 3.5 cm cuff erosion (OR 6.2, 95% CI 1.3–29.5). Conclusions: Men with a history of radiation who underwent placement of a 3.5 cm artificial urinary sphincter cuff experienced an increased (21%) risk of cuff erosion. References 1 : Treatment of urinary incontinence by implantable prosthetic sphincter. Urology1973; 1: 252. Google Scholar 2 : Use of a double cuff AMS800 urinary sphincter for severe stress incontinence. J Urol1993; 149: 283. Link, Google Scholar 3 : Outcomes following revisions and secondary implantation of the artificial urinary sphincter. J Urol2005; 173: 1242. 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Link, Google Scholar © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byHuang M, Huffman P, Dani H, Knijnik P, da Silva A, Burnett A, Mostwin J, Wright E and Cohen A (2022) Association between Previous Pelvic Radiation and All-Cause and Cause-Specific Failure of Replacement Artificial Urinary SphinctersJournal of Urology, VOL. 207, NO. 6, (1268-1275), Online publication date: 1-Jun-2022.Moser D, Kaufman M, Milam D, Johnsen N, Cleves M, Broghammer J, Brant W, Jones L, Brady J, Gross M, Jani K and Henry G (2018) Impact of Radiation and Transcorporeal Artificial Sphincter Placement in Patients with Prior Urethral Cuff Erosion: Results from a Retrospective Multicenter AnalysisJournal of Urology, VOL. 200, NO. 6, (1338-1343), Online publication date: 1-Dec-2018.Kaufman M, Milam D, Johnsen N, Cleves M, Broghammer J, Brant W, Jones L, Brady J, Gross M and Henry G (2017) Prior Radiation Therapy Decreases Time to Idiopathic Erosion of Artificial Urinary Sphincter: A Multi-Institutional AnalysisJournal of Urology, VOL. 199, NO. 4, (1037-1041), Online publication date: 1-Apr-2018.Rivera M, Linder B, Ziegelmann M, Viers B, Rangel L and Elliott D (2015) The Impact of Prior Radiation Therapy on Artificial Urinary Sphincter Device SurvivalJournal of Urology, VOL. 195, NO. 4 Part 1, (1033-1037), Online publication date: 1-Apr-2016.Mock S, Dmochowski R, Brown E, Reynolds W, Kaufman M and Milam D (2015) The Impact of Urethral Risk Factors on Transcorporeal Artificial Urinary Sphincter Erosion Rates and Device SurvivalJournal of Urology, VOL. 194, NO. 6, (1692-1696), Online publication date: 1-Dec-2015.Morey A (2015) Re: Risk Factors for Erosion of Artificial Urinary Sphincters: A Multicenter Prospective StudyJournal of Urology, VOL. 193, NO. 6, (2015-2016), Online publication date: 1-Jun-2015. Volume 193Issue 2February 2015Page: 593-597 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.Keywordscomplicationsurethrastressurinary bladderartificialurinary incontinenceurinary sphincterMetricsAuthor Information Jay Simhan More articles by this author Allen F. Morey Financial interest and/or other relationship with Coloplast and American Medical Systems. More articles by this author Nirmish Singla More articles by this author Timothy J. Tausch More articles by this author J. Francis Scott More articles by this author Gary E. Lemack Financial interest and/or other relationship with Afferent and Allergan. More articles by this author Claus G. Roehrborn More articles by this author Expand All Advertisement PDF downloadLoading ...