Dorsolateral fibromuscular tissue preservation during artificial urinary sphincter cuff placement is associated with low infection and erosion rates Journal Article


Authors: Cheung, F.; Fathollahi, A.; Vertosick, E.; Jarvis, T. R.; Katz, D.; Sandhu, J. S.
Article Title: Dorsolateral fibromuscular tissue preservation during artificial urinary sphincter cuff placement is associated with low infection and erosion rates
Abstract: Objectives: To present a modified technique in artificial urinary sphincter (AUS) placement that is associated with low rates of erosion and infection in a high-risk population. Patients and Methods: After Institutional Review Board approval, we identified patients who underwent primary AUS placement using the modified technique between January 2007 and November 2015. Our modification consists of preserving the dorsolateral fibromuscular tissue surrounding the bulbar urethra and horizontally transecting the ventral bulbospongiosus muscle during urethral cuff placement. Preoperative variables such as radiotherapy (RT) and bladder neck contractures were recorded. Effectiveness and complications including infections, erosions, and re-operations were recorded at follow-up. Results: The new technique was used on 208 patients: 40% had a history of RT, including 15% who had had a salvage radical prostatectomy; 26% had had previous bladder neck contractures. No patients developed infection. Overall, erosion occurred in six (2.9%) patients and spontaneous erosions occurred in two (0.9%) during the study period. In all, 21 patients underwent re-operation for device failure. The probability of re-operation for ‘any’ reason was 7% (95% confidence interval [CI] 4–12%) at 1 year. The 1-year social continence rate was 74% (95% CI 67–81%). Conclusion: Preservation of dorsolateral fibromuscular tissue during AUS placement is an effective means to achieve a low risk of erosions. Our modified technique is safe with low infection and erosion rates, whilst maintaining good functional outcomes despite a high-risk population. © 2018 The Authors BJU International © 2018 BJU International Published by John Wiley & Sons Ltd
Keywords: infection; prostatectomy; stress incontinence; artificial urinary sphincter; erosion
Journal Title: BJU International
Volume: 123
Issue: 2
ISSN: 1464-4096
Publisher: Wiley Blackwell  
Date Published: 2019-02-01
Start Page: 328
End Page: 334
Language: English
DOI: 10.1111/bju.14476
PUBMED: 29972627
PROVIDER: scopus
PMCID: PMC8672706
DOI/URL:
Notes: Export Date: 1 February 2019 -- Source: Scopus
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MSK Authors
  1. Jaspreet Sandhu
    123 Sandhu
  2. Emily Vertosick
    108 Vertosick
  3. Felix Cheung
    2 Cheung