Permanent Bulbar Urethral Ligation: Emerging Treatment Option for Incontinent Men With End-stage Urethra

VanDyke, Maia E.; Viers, Boyd R.; Pagliara, Travis; Scott, Jeremy; Shakir, Nabeel; Dugi, Daniel; Cordon, Billy H.; Hofer, Matthias; Morey, Allen F.

doi:10.1016/j.urology.2017.02.042

Cited by 8 publications

(7 citation statements)

References 29 publications

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“…Erosion patients were discharged with a urethral Foley in place with healing confirmed by voiding cystourethrogram at 1 month. At 6 months after explantation, options including conservative management, AUS re‐implantation, or permanent bulbar urethral ligation were discussed with patient depending upon risk factors and patient goals.…”

Section: Methodsmentioning

confidence: 99%

Erosion rates of 3.5‐cm artificial urinary sphincter cuffs are similar to larger cuffs

et al. 2018

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Section: Methodsmentioning

confidence: 99%

Erosion rates of 3.5‐cm artificial urinary sphincter cuffs are similar to larger cuffs

et al. 2018

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“…This finding is clinically significant because it allows urologists to set appropriate long‐term expectations for patients with extensive erosions. Urethral ligation and permanent SPT drainage have been shown to be effective with good overall patient quality of life 21 . This treatment option should be discussed with patients after AUS cuff erosions.…”

Section: Discussionmentioning

confidence: 99%

Long‐term lower urinary tract sequelae following AUS cuff erosion

Chertack

Caldwell

Joice

et al. 2021

Neurourology and Urodynamics

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To examine the rate of lower urinary tract complications (LUTC) and urinary diversion (UD) after artificial urinary sphincter (AUS) explantation with the acute reconstruction of AUS cuff erosion defects. Methods:We performed a retrospective study of patients who underwent in-situ urethroplasty (ISU) for AUS cuff erosion from June 2007 to December 2020. Outcomes included LUTC (urethral stricture, diverticulum, fistula), AUS reimplantation, and UD. Defect size was prospectively estimated acutely and a subanalysis was performed to determine the impact of erosion severity (small erosions [<33% circumferential defect] and large erosions [≥33%]) on these outcomes. Kaplan-Meier curves were created to compare survival between the two groups.Results: A total of 40 patients underwent ISU for urethral cuff erosion. The median patient age was 76 years old with a median erosion circumference of 46%. The overall LUTC rate was 30% (12/40) with 35% (14/40) of patients requiring permanent UD. Secondary AUS placement occurred in 24/40 (60%) patients with 11/24 (46%) leading to repeat erosion. On subanalysis, small erosion was associated with improved LUTC-free and UD-free survival but not associated with AUS reimplantation.Conclusions: Lower urinary tract complications are common after AUS cuff erosion and can lead to the need for permanent UD. Patients with larger erosions are more likely to undergo UD and reach this end-stage condition earlier compared to patients with small erosions.

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“…This approach can be done laparoscopically to reduce morbidity. Permanent perineal urethral ligation in males can be performed in cases where the bladder outlet is devastated and bladder preserving cutaneous diversion has resulted in ongoing urethral incontinence ( 57 , 58 ).…”

Section: Non-reconstructable “Devastated” Bladder Outlet With or Withmentioning

confidence: 99%

Posterior urethral stenosis after prostate cancer treatment: contemporary options for definitive management

Kahokehr

Peterson

Lentz

2018

Transl. Androl. Urol.

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Permanent Bulbar Urethral Ligation: Emerging Treatment Option for Incontinent Men With End-stage Urethra

Cited by 8 publications

References 29 publications

Erosion rates of 3.5‐cm artificial urinary sphincter cuffs are similar to larger cuffs

Erosion rates of 3.5‐cm artificial urinary sphincter cuffs are similar to larger cuffs

Long‐term lower urinary tract sequelae following AUS cuff erosion

Posterior urethral stenosis after prostate cancer treatment: contemporary options for definitive management

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