Prospective follow‐up study of artificial urinary sphincter placement preserving the bulbospongiosus muscle

Serra, Argimiro Collado; Domínguez-Escrig, José; Gómez-Ferrer, Á.; Miranda, Emilio Batista; Rubio‐Briones, J.; Narbón, Eduardo Solsona

doi:10.1002/nau.23119

Cited by 19 publications

(16 citation statements)

References 27 publications

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“…A further potential bias of our study is that the cuff placement technique was not analyzed. A bulbospongiosus-sparing technique to reduce atrophy [6] was not performed in our participating centers. Transcorporal cuff placement was, however, applied in patients with small urethral circumferences, though precise analysis was not possible due to inconsistent/missing data.…”

Section: Discussionmentioning

confidence: 99%

Artificial Urinary Sphincter Cuff Size Predicts Outcome in Male Patients Treated for Stress Incontinence: Results of a Large Central European Multicenter Cohort Study

et al. 2019

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PurposeThe aim was to study the correlation between cuff size and outcome after implantation of an AMS 800 artificial urinary sphincter.MethodsA total of 473 male patients with an AMS 800 sphincter implanted between 2012 and 2014 were analyzed in a retrospective multicenter cohort study performed as part of the Central European Debates on Male Incontinence (DOMINO) Project.ResultsSingle cuffs were implanted in 54.5% and double cuffs in 45.5% of the patients. The cuffs used had a median circumference of 4.5 cm. Within a median follow of 18 months, urethral erosion occurred in 12.8% of the cases and was associated significantly more often with small cuff sizes (P<0.001). Multivariate analysis showed that, apart from cuff size (P=0.03), prior irradiation (P<0.001) and the penoscrotal approach (P=0.036) were associated with an increased erosion rate. Continence rate tended to be highest with median cuff sizes (4–5.5 cm).ConclusionsApart from irradiation and the penoscrotal approach, small cuff size is a risk factor for urethral erosion. Results are best with cuff sizes of 4.5–5.5 cm.

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Section: Discussionmentioning

confidence: 99%

Artificial Urinary Sphincter Cuff Size Predicts Outcome in Male Patients Treated for Stress Incontinence: Results of a Large Central European Multicenter Cohort Study

et al. 2019

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“…This involved a similar initial dissection, but was associated with increased revision rates, probably due to muscle atrophy under the cuff. More recently, Collado Serra et al reported their results using a bulbospongiosus muscle‐preserving technique, which included dorsal urethral dissection similar to our present technique. They reported their results on 82 patients over an 11‐year period, reporting a 77% dry rate at 1 year and, notably, only one erosion during the that time.…”

Section: Discussionmentioning

confidence: 66%

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

et al. 2018

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“…Serra et al [37], in 2016, described a bulbospongiosus-muscle-sparing AUS implantation technique, with the idea that muscle preservation may decrease the risk of urethral injury during the dissection and may also better preserve the flow of blood to the urethra, thus preventing both long-and short-term complications. In this series of 82 consecutive patients, Serra et al reported an AUS survival rate, defined as the loss of continence or mechanical failure during follow-up, of 95.5% (95%CI: 89.4-100%) at 24 mos and 62.6% (95%CI: 45.5-79.6%) at 60 mos, similar to our findings, while somewhat better functional outcomes were reported (dry rate of 76.8% and social continence rate of 92%).…”

Section: Discussionmentioning

confidence: 99%

Transalbugineal Artificial Urinary Sphincter: A Refined Implantation Technique to Improve Surgical Outcomes

Sacco

Marino

Gandi

et al. 2023

JCM

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The artificial urinary sphincter (AUS) implantation is an effective treatment of post-prostatectomy urinary incontinence (PPI). Still, it may result in troublesome complications such as intraoperative urethral lesion and postoperative erosion. Based on the multilayered structure of the tunica albuginea of the corpora cavernosa, we evaluated an alternative transalbugineal surgical technique of AUS cuff placement with the aim to decrease perioperative morbidity while preserving the integrity of the corpora cavernosa. A retrospective study was conducted in a tertiary referral center from September 2012 to October 2021, including 47 consecutive patients undergoing AUS (AMS800®) transalbugineal implantation. At a median (IQR) follow-up of 60 (24–84) months, no intraoperative urethral injury and only one noniatrogenic erosion occurred. The actuarial 12 mo and 5 yr overall erosion-free rates were 95.74% (95% CI: 84.04–98.92) and 91.76% (95% CI: 75.23–97.43), respectively. In preoperatively potent patients, the IIEF-5 score remained unchanged. The social continence (0–1 pads per day) rate was 82.98% (CI 95%: 68.83–91.10) at 12 mos and 76.81% (CI 95%: 60.56–87.04) at 5 yrs follow-up. Our technically refined approach to AUS implantation may help to avoid intraoperative urethral lesions and lower the risk of subsequent erosion without compromising sexual function in potent patients. Prospective and adequately powered studies are necessary to achieve more compelling evidence.

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Prospective follow‐up study of artificial urinary sphincter placement preserving the bulbospongiosus muscle

Cited by 19 publications

References 27 publications

Artificial Urinary Sphincter Cuff Size Predicts Outcome in Male Patients Treated for Stress Incontinence: Results of a Large Central European Multicenter Cohort Study

Artificial Urinary Sphincter Cuff Size Predicts Outcome in Male Patients Treated for Stress Incontinence: Results of a Large Central European Multicenter Cohort Study

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

Transalbugineal Artificial Urinary Sphincter: A Refined Implantation Technique to Improve Surgical Outcomes

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