Editorial Comment

Abstract

This is an unusual case study of 2 patients with cuff erosion who were managed conservatively despite artificial urinary sphincter (AUS) cuff erosion for 5-15 years. As the author points out, these patients are quite unique, and most likely this case study would not be applicable to the general population of AUS patients. Both patients had congenital anomalies with placement of the sphincters at the bladder neck for continence. In addition, they had difficult surgical anatomy, and AUS removal would potentially be devastating to their quality of life as they may not be able to undergo another surgery and be rendered incontinent. The majority of patients seen by urologists do not have medical problems of this severity and would be candidates for repeat AUS placement in the future. The author also notes that 1 patient did have a complication of bladder stone formation on the eroded sphincter requiring several operations to remove the stones, including 1 open stone removal. Nevertheless, the patient continued to refuse AUS removal despite these complications. Review of Single-surgeon 10-Year Experience With Artificial Urinary Sphincter With Report of Sterile Cuff Erosion Managed NonsurgicallyUrologyVol. 85Issue 1PreviewTo review our experience with artificial urinary sphincter (AUS) and to consider the role of nonsurgical management of sterile AUS cuff erosion. Full-Text PDF ReplyUrologyVol. 85Issue 1PreviewWe reviewed our longitudinal experience and complications with artificial urinary sphincter (AUS) implantation over a 10-year time frame in a relatively large cohort of patients. We focused on the unique and unusual experience of 2 patients who developed sterile cuff erosion, yet opted to avoid surgical explantation despite our recommendations otherwise. They continued to remain continent and free of infection for several years despite chronic AUS cuff erosion, prompting us to query the need for uniformly explanting the AUS after sterile cuff erosion. Full-Text PDF