Artificial Urinary Sphincter Complications: Risk Factors, Workup, and Clinical Approach

Khouri, Roger K.; Ortiz, Nicolás; Dropkin, Benjamin M.; Joice, Gregory; Baumgarten, Adam S.; Morey, Allen F.; Hudak, Steven J.

doi:10.1007/s11934-021-01045-x

Cited by 21 publications

(18 citation statements)

References 106 publications

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“…The most common complications of AUS placement include infection, device malfunction, and urethral erosion. 1 Erosion of bowel by AUS tubing is exceedingly rare. To our knowledge there has only been one previous report of AUS tubing erosion into the bowel.…”

Section: What Complication Of Aus Placement Is Most Likely Shown In T...mentioning

confidence: 99%

Delayed Sigmoid Colon Erosion by Artificial Urinary Sphincter Tubing

Shieh

Shaw

Decker

et al. 2022

Urology

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Section: What Complication Of Aus Placement Is Most Likely Shown In T...mentioning

confidence: 99%

Delayed Sigmoid Colon Erosion by Artificial Urinary Sphincter Tubing

Shieh

Shaw

Decker

et al. 2022

Urology

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“…[3][4][5] Diabetes mellitus (DM), commonly known to cause peri-or postoperative complications, has been reported to increase the risk of erosion or infection in AUS implantation. [6][7][8] We previously reported that DM was a significant risk factor for revision surgery. 9 Several other studies have also reported that DM was a risk factor for AUS revision surgery 6,7 ; however, there are few studies regarding the assessment of surgical outcomes and quality of life (QOL) after AUS surgery in patients with DM.…”

Section: Introductionmentioning

confidence: 99%

“…We previously reported that DM was a significant risk factor for revision surgery 9 . Several other studies have also reported that DM was a risk factor for AUS revision surgery 6,7 ; however, there are few studies regarding the assessment of surgical outcomes and quality of life (QOL) after AUS surgery in patients with DM 6 . We thus conducted subanalyses on a sample population from our previous study.…”

Section: Introductionmentioning

confidence: 99%

“…Nevertheless, AUS requires revision surgery at a constant rate because of erosion, infection, mechanical failure, or urethral atrophy 3–5 . Diabetes mellitus (DM), commonly known to cause peri‐ or postoperative complications, has been reported to increase the risk of erosion or infection in AUS implantation 6–8 . We previously reported that DM was a significant risk factor for revision surgery 9 .…”

Section: Introductionmentioning

confidence: 99%

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Outcomes of artificial urinary sphincter implantation in patients with diabetes mellitus: A subgroup analysis

et al. 2022

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Objectives To estimate the surgical and quality‐of‐life outcomes of artificial urinary sphincter implantation in patients with diabetes mellitus (DM). Subanalyses were performed using the same population as that in our previous multicenter, prospective, observational study. Methods A total of 135 male patients who underwent primary artificial urinary sphincter implantation were divided into two groups: those with and without DM. The revision‐free rates, that is, the percentage of patients who did not require revision surgery, were compared between patients with and without DM. The number of urinary pads required per day, International Consultation on Incontinence Questionnaire‐Short Form, and King's Health Questionnaire were used to compare the continence status and quality of life (QOL) between the two groups preoperatively and at 1, 3, and 12 months after surgery. Results Revision‐free rates were significantly lower in the DM group (83.9%, 77.4%, and 67.8% at 1, 2, and 3 years after implantation, respectively) than in the non‐DM group (95.5%, 92.5%, and 85.5% at 1, 2, and 3 years after implantation, respectively). Both continence status and QOL, assessed by questionnaires, markedly improved after surgery in patients with and without DM. Conclusions Despite differences in the durability of the artificial urinary sphincters, patients with DM can obtain as much benefit from artificial urinary sphincter implantation regarding continence and quality‐of‐life improvement as patients without DM. Therefore, DM was not considered a comorbidity that contraindicated artificial urinary sphincter implantation. Additional large‐scale studies are required to verify our findings.

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“…Despite abundant literature on medical conditions linked with AUS cuff erosion, less information exists addressing the specific presenting signs and symptoms of this troublesome condition. Signs and symptoms which have been attributed to cuff erosion include hematuria, dysuria, and recurrent SUI (21)(22)(23). We predicted that physical exam findings of scrotal inflammation predict AUS cuff erosion.…”

Section: Introductionmentioning

confidence: 99%

Presenting signs and symptoms of artificial urinary sphincter cuff erosion

et al. 2022

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Purpose: To characterize the most common presentation and clinical risk factors for artificial urinary sphincter (AUS) cuff erosion to distinguish the relative frequency of symptoms that should trigger further evaluation in these patients. Materials and Methods: We retrospectively reviewed our tertiary center database to identify men who presented with AUS cuff erosion between 2007 -2020. A similar cohort of men who underwent AUS placement without erosion were randomly selected from the same database for symptom comparison. Risk factors for cuff erosion -pelvic radiation, androgen deprivation therapy (ADT), high-grade prostate cancer (Gleason score ≥ 8) -were recorded for each patient. Presenting signs and symptoms of cuff erosion were grouped into three categories: obstructive symptoms, worsening incontinence, and localized scrotal inflammation (SI). Results: Of 893 men who underwent AUS placement during the study interval, 61 (6.8%) sustained cuff erosion. Most erosion patients (40/61, 66%) presented with scrotal inflammatory changes including tenderness, erythema, and swelling. Fewer men reported obstructive symptoms (26/61, 43%) and worsening incontinence (21/61, 34%). Men with SI or obstructive symptoms presented significantly earlier than those with worsening incontinence (SI 14 ± 18 vs. obstructive symptoms 15 ± 16 vs. incontinence 37 ± 48 months after AUS insertion, p<0.01). Relative to the non-erosion control group (n=61), men who suffered erosion had a higher prevalence of pelvic radiation (71 vs. 49%, p=0.02). Conclusion: AUS cuff erosion most commonly presents as SI symptoms. Obstructive voiding symptoms and worsening incontinence are also common. Any of these symptoms should prompt further investigation of cuff erosion.

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Artificial Urinary Sphincter Complications: Risk Factors, Workup, and Clinical Approach

Cited by 21 publications

References 106 publications

Delayed Sigmoid Colon Erosion by Artificial Urinary Sphincter Tubing

Delayed Sigmoid Colon Erosion by Artificial Urinary Sphincter Tubing

Outcomes of artificial urinary sphincter implantation in patients with diabetes mellitus: A subgroup analysis

Presenting signs and symptoms of artificial urinary sphincter cuff erosion

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