568 ARTIFICIAL URINARY SPHINCTER CUFF DOWNSIZING VERSUS PRESSURE REGULATING BALLOON GRADIENT INCREASE AS REVISION TECHNIQUES: A FREEDOM FROM COMPLICATION ANALYSIS

Abstract

You have accessJournal of UrologyUrodynmaics/Incontinence/Female Urology: Incontinence, Evaluation & Therapy (I)1 Apr 2013568 ARTIFICIAL URINARY SPHINCTER CUFF DOWNSIZING VERSUS PRESSURE REGULATING BALLOON GRADIENT INCREASE AS REVISION TECHNIQUES: A FREEDOM FROM COMPLICATION ANALYSIS O. Lenaine Westney, H. Henry Lai, Timothy B. Boone, Jerilyn Latini, and Edward J. McGuire O. Lenaine WestneyO. Lenaine Westney Houston, TX More articles by this author , H. Henry LaiH. Henry Lai St. Louis, MO More articles by this author , Timothy B. BooneTimothy B. Boone Houston, TX More articles by this author , Jerilyn LatiniJerilyn Latini Ann Arbor, MI More articles by this author , and Edward J. McGuireEdward J. McGuire Ann Arbor, MI More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.1964AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The longevity of artificial urinary sphincter survival is compromised by mechanical failures, urethral atrophy and erosion. Techniques for improving or restoring incontinence after initial AUS are focused on manipulation of the cuff or the reservoir. Our aim is determine if there is a difference in the rate and timing of subsequent complications between patients who undergo cuff downsizing or a pressure regulating balloon change as a mechanism of AUS revision. METHODS The AUS databases from 4 institutions were reviewed for male patients with the following characteristics: 1) First revision of artificial urinary sphincter consisting of either cuff downsizing at the original cuff site or replacement of a higher pressure regulating balloon and 2) Patients who underwent replacement of all components including a downsized cuff and the same reservoir pressure with preservation of the original cuff site. Statistical analysis was performed using STATA/SE v. 12.1 for descriptive statistics and mean difference analysis. Freedom from complications was computed using Kaplan-Maier survival analysis. RESULTS 73 patients met the inclusion criteria. Four patients were excluded on the basis of missing critical data. 38 patients underwent cuff down sizing while 29 underwent PRB increase with a mean time from original AUS to revision of 43.9 (SD +/− 38.3) and 28.7 (SD +/− 35.4) months, respectively. A total of 24 patients (12 per group) had complications during the post revision follow-up period at a median of 20 months (range, 2.4 - 127.2). Patients in both groups were equally likely to experience a complication. (p=0.536) The mean time from revision to complication was not statistically different between the groups. (p=0.312) The freedom from complication curves were similar. (p=0.614) (Figure 1). CONCLUSIONS Cuff downsizing and PRB increase represent alternative methods to correcting persistent or recurrent urinary incontinence after initial artificial urinary sphincter placement. This data does not demonstrate a difference in number of complications, mean time to complications or freedom from complication. The distribution of complication types in each group appear different, however, the number of events limited analysis. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e233 Peer Review Report Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information O. Lenaine Westney Houston, TX More articles by this author H. Henry Lai St. Louis, MO More articles by this author Timothy B. Boone Houston, TX More articles by this author Jerilyn Latini Ann Arbor, MI More articles by this author Edward J. McGuire Ann Arbor, MI More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...