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Surgical Reconstruction of Urethral Injury After Artificial Urinary Sphincter Infection-Erosion

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Textbook of Male Genitourethral Reconstruction

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Abstract

Although currently still the gold standard treatment for post-protatectomy urinary incontinence, the artificial urinary sphincter (AUS, AMS800) is an invasive procedure with an inherent risk for infection and erosion. Urethral injury results from AUS cuff infection-erosion, and may lead to urethral stricture. The data describing the types and success of urethral reconstruction after AUS cuff infection-erosion as well as the rates of successful AUS reimplantation in these patients are scanty.

In this chapter, we aim to outline what the scientific literature, and what we personally believe, are the factors that are useful and/or necessary to recognize in order to mitigate these risks, including both patient related factors and surgeon related factors. We also review the various options available for concomitant or staged urethral reconstruction after infection and/or erosion of the AUS cuff.

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References

  1. Srivastava A, Joice GA, Patel HD, Manka MG, Sopko NA, Wright EJ. Causes of UAS failure and strategies for surgical revision: implications of device component survival. Eur Urol. 2018; https://doi.org/10.1016/j.euf.2018.02.014.

  2. Brant WO, Erickson BA, Elliott SP, et al. Risk factors for erosion of the artificial urinary sphincters: a multicenter prospective study. Urology. 2014;84:934–9.

    Article  Google Scholar 

  3. Raj GV, Peterson AC, Webster GD. Outcomes following erosions of the artificial urinary sphincter. J Urol. 2006;175:2186–90.

    Article  Google Scholar 

  4. Hofer MD, Morey AF, Sheth K, Tausch TJ, Siegel J, Cordon BH, Bury MI, Cheng EY, Sharma AK, Gonzalez CM, Kaplan WE, Kavoussi NL, Klein A, Roehrborn CG. Low serum testosterone level predisposes to artificial urinary sphincter cuff erosion. Urology. 2016 Nov;97:245–9.

    Article  Google Scholar 

  5. Kretschmer A, Buchner A, Grabbert M, et al. Risk factors for artificial urinary sphincter failure. World J Urol. 2016;34:595–602.

    Article  Google Scholar 

  6. Lai HH, Boone TB. Complex artificial urinary sphincter revision and reimplantation cases: how do they fare compared to virgin cases? J Urol. 2012;187:951–5.

    Article  Google Scholar 

  7. Martins FE, Boyd SD. Artificial urinary sphincter in patients following major pelvic surgery and/or radiotherapy: are they less favorable candidates? J Urol. 1995;153:1188–93.

    Article  CAS  Google Scholar 

  8. Wang Y, Hadley H. Experiences with the artificial urinary sphincter in the irradiated patient. J Urol. 1992;147:612–3.

    Article  CAS  Google Scholar 

  9. Walsh IK, Williams SG, Mahendra V, et al. Artificial urinary sphincter implantation in the irradiated patient: safety, efficacy and satisfaction. BJU Int. 2002;89:364–8.

    Article  CAS  Google Scholar 

  10. Kaufman MR, Milam DF, Johnsen NV, Cleves MA, Broghammer JA, Brant WO, Jones LA, Brady JD, Gross MS, Henry GD. Prior radiation therapy decreases time to idiopathic erosion of artificial urinary sphincter: a multi-institutional analysis. J Urol. 2018 Apr;199(4):1037–41.

    Article  Google Scholar 

  11. Anger JT, Raj GV, Delvecchio FC, Webster GD. Anastomotic contracture and incontinence after radical prostatectomy: a graded approach to management. J Urol. 2005;173:1143–6.

    Article  Google Scholar 

  12. Li H, Gill BC, Nowacki AS, et al. Therapeutic durability of the male transobturator sling: mid-term patient-reported outcomes. J Urol. 2012;187:1331–5.

    Article  Google Scholar 

  13. Magera JS Jr, Inman BA, Elliott DS. Does preoperative topical antimicrobial scrub reduce positive surgical site culture rates in men undergoing artificial urinary sphincter placement? J Urol. 2007;178(4 Pt 1):1328–32; discussion 1332.

    Article  Google Scholar 

  14. Gross MS, Broghammer JA, Kaufman MR, et al. Urethral stricture outcomes after artificial urinary sphincter cuff erosion: results from a multicenter retrospective analysis. Urology. 2017;104:198–203.

    Article  Google Scholar 

  15. Henry GD, Graham SM, Cornell RJ, et al. A multicenter study on the perineal versus penoscrotal approach for implantation of an artificial urinary sphincter: cuff size and control of male stress urinary incontinence. J Urol. 2009 Nov;182(5):2404–9.

    Article  Google Scholar 

  16. O’Connor RC, Gerber GS, Avila D, et al. Comparison of outcomes after single or double-cuff artificial urinary sphincter insertion. Urology. 2003 Oct;62(4):723–6.

    Article  Google Scholar 

  17. O’Connor RC, Lyon MB, Guralnick ML, Bales GT. Long-term follow-up of single versus double cuff artificial urinary sphincter insertion for the treatment of severe postprostatectomy stress urinary incontinence. Urology. 2008 Jan;71(1):90–3.

    Article  Google Scholar 

  18. Guralnick ML, Miller E, Toh KL, Webster GD. Transcorporal artificial urinary sphincter cuff placement in cases requiring revision for erosion and urethral atrophy. J Urol. 2002;167(5):2075–8; discussion 2079

    Article  Google Scholar 

  19. Smith PJ, Hudak SJ, Scott JF, et al. Transcorporal artificial urinary sphincter cuff placement is associated with a higher risk of postoperative urinary retention. Can J Urol. 2013 Jun;20(3):6773–7.

    PubMed  Google Scholar 

  20. McGeady JB, McAninch JW, Truesdale MD, et al. Artificial urinary sphincter placement in compromised urethras and survival: comparison of virgin, radiated and reoperative cases. J Urol. 2014;192(6):1756–61.

    Article  Google Scholar 

  21. Léon P, Chartier-Kastler E, Roupêt M, Ambrogi V, Mozer P, Phé V. Long-term functional outcomes after artificial urinary sphincter implantation in men with stress urinary incontinence. BJU Int. 2015;115:915–57.

    Article  Google Scholar 

  22. Agarwal DK, Linder BJ, Elliott DS. Artificial urinary sphincter urethral erosions: temporal pattern, management and incidence of preventable erosions. Indian J Urol. 2017 Jan-Mar;33(1):26–9.

    PubMed  PubMed Central  Google Scholar 

  23. Sandhu JS. Artificial urinary sphincter: the workhorse for the treatment of male stress urinary incontinence. Eur Urol. 2013;63:690–1.

    Article  Google Scholar 

  24. Rozanski AT, Tausch TJ, Ramirez D, et al. Immediate urethral repair during explantation prevents stricture formation after artificial urinary sphincter cuff erosion. J Urol. 2014;192:442–6.

    Article  Google Scholar 

  25. Chertack N, Chaparala H, Angermeier KW, Montague DK, Wood HM. Foley or fix: a comparative analysis of reparative procedures at the time of explantation of artificial urinary sphincter for cuff erosion. Urology. 2016;90:173–8.

    Article  Google Scholar 

  26. Martins FE, Marcelino JP, Sandul A, et al. Urethral reconstruction following artificial urinary sphincter cuff infection-erosion. Eur Urol Suppl. 2016;15(3):e1156.

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Urology, University of Lisbon, School of Medicine, CHLN/Hospital Santa Maria, Lisbon, Portugal

    Francisco E. Martins

  2. Department of Surgery, Division of Urology, ULSNA, Hospital José Maria Grande, Portalegre, Portugal

    Natalia M. Martins

  3. Salt Lake City Veterans Affairs Medical Center, Salt Lake City, UT, USA

    William O. Brant

Authors
  1. Francisco E. Martins
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  2. Natalia M. Martins
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  3. William O. Brant
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Editor information

Editors and Affiliations

  1. School of Medicine, University of Lisbon, Lisbon, Portugal

    Francisco E. Martins

  2. Kulkarni Reconstructive Urology Center, Pune, India

    Sanjay B. Kulkarni

  3. Department of Urology, Mayo Clinic, Rochester, MN, USA

    Tobias S. Köhler

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Martins, F.E., Martins, N.M., Brant, W.O. (2020). Surgical Reconstruction of Urethral Injury After Artificial Urinary Sphincter Infection-Erosion. In: Martins, F.E., Kulkarni, S.B., Köhler, T.S. (eds) Textbook of Male Genitourethral Reconstruction. Springer, Cham. https://doi.org/10.1007/978-3-030-21447-0_26

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  • DOI: https://doi.org/10.1007/978-3-030-21447-0_26

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-21446-3

  • Online ISBN: 978-3-030-21447-0

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