Artificial Urinary Sphincter Cuff Erosion Heat Map Shows Similar Anatomical Characteristics for Transcorporal and Standard Approach

Nicolas M. Ortiz, Avery R. Wolfe, Adam S. Baumgarten, Ellen E. Ward, Maia E. VanDyke, Steven J. Hudak, Allen F. Morey

Research output: Contribution to journalArticlepeer-review

Abstract

PURPOSE: We describe and compare artificial urinary sphincter cuff erosion sites and associated clinical implications. MATERIALS AND METHODS: We retrospectively reviewed men who presented with artificial urinary sphincter erosion treated by a single surgeon between 2007 and 2019 at a tertiary medical center. Transcorporal indications included complications of prior anti-incontinence procedures and prior urethral reconstruction. Location of artificial urinary sphincter cuff erosion defects was assessed by cystoscopy prior to device explantation, and findings were stratified into patients who had transcorporal vs standard artificial urinary sphincter placement. RESULTS: Out of 723 artificial urinary sphincter cases in 611 patients we identified 54 (7.5%) cuff erosions. Erosion developed in 15 of 82 (18.3%) cases of transcorporal artificial urinary sphincter and 39 of 641 (6.1%) cases of standard artificial urinary sphincter (p <0.05). Artificial urinary sphincter cuff erosions occurred predominantly ventrally in both groups (66.7% for transcorporal and 79.5% for standard artificial urinary sphincter, p=0.4) followed by lateral urethral location (33.3% transcorporal and 20.5% standard, p=0.3). Dorsal erosions were rare in both groups (20% transcorporal and 5.1% standard, p=0.1). History of artificial urinary sphincter and previous erosion were associated with transcorporal artificial urinary sphincter erosion. History of radiotherapy, prior urethroplasty, hypogonadism and urethral cuff size were similar between groups. CONCLUSIONS: Artificial urinary sphincter cuff erosions appear to occur ventrally and laterally in most patients regardless of cuff placement. Dorsal erosions were the least common in both groups. The protective effect of transcorporal artificial urinary sphincter could not be conclusively demonstrated.

Original languageEnglish (US)
Pages (from-to)1027-1032
Number of pages6
JournalThe Journal of urology
Volume204
Issue number5
DOIs
StatePublished - Nov 1 2020

Keywords

  • artificial
  • stress
  • urinary incontinence
  • urinary sphincter

ASJC Scopus subject areas

  • Urology

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