1191 INDICATIONS FOR REVISION OF ARTIFICIAL URINARY SPHINCTER AND MODIFYING RISK FACTORS FOR DEVICE-RELATED MORBIDITY

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You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Incontinence - Evaluation & Therapy II1 Apr 20121191 INDICATIONS FOR REVISION OF ARTIFICIAL URINARY SPHINCTER AND MODIFYING RISK FACTORS FOR DEVICE-RELATED MORBIDITY Ifeanyi Anusionwu and E. James Wright Ifeanyi AnusionwuIfeanyi Anusionwu Baltimore, MD More articles by this author and E. James WrightE. James Wright Baltimore, MD More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1436AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The aim of our study is to evaluate the causes for failure of artificial urinary sphincter (AUS) in a contemporary series, and to detect modifiable risk factors for device−related morbidity. We also report our outcome after AUS revision. METHODS We retrospectively reviewed the medical records of consecutive patients who underwent revision of AUS at our institution by a single surgeon over the last 5 years (2006 to 2011). RESULTS There were 53 AUS revisions performed on 34 patients. Median age of the population was 69 years. The indications for AUS revision are shown in Table 1. Urethral atrophy was the most common indication for AUS revision. Fourteen patients (41%) underwent more than one revision. Table 2 shows the number of revisions undergone by patients. Forty−three percent of those who underwent multiple revisions had a history of radiation therapy, as opposed to 25% of those who underwent one revision, but the difference was not statistically significant (P=0.45). Seven patients had urethral catheterization in the setting of an activated AUS while admitted to a non−urologic service; all of these patients developed cuff erosion with or without infection. Fifty four percent of urethral erosions were associated with such traumatic catheterizations. After revision, 80% of patients with an AUS in place were continent at mean follow up 27 months (median 20 months). Table 1. Indications for revision of artificial urinary sphincter Indication for Revision Number of revisions (%) Urethral atrophy 31(58%) Erosion 13(25%) Infection 2(4%) Mechanical failure 1(2%) Patient discomfort 5(9%) Need for transurethral procedure 1(2%) Table 2. Number of revisions undergone by patients Number of revisions Number of patients (%) 1 revision 20(59%) 2 revisions 11(32%) 3 revisions 1(3%) 4 revisions 2(6%) CONCLUSIONS Urethral atrophy remains the most common reason for AUS revision. Forty−one percent of patients undergoing AUS revision will have repeated revisions. More than half of all urethral erosions are secondary to urethral catheterization in the setting of an activated sphincter, suggesting that some of the risk of device−related morbidity may be modifiable. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e482 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ifeanyi Anusionwu Baltimore, MD More articles by this author E. James Wright Baltimore, MD More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...