Abstract
Abstract Introduction: Artificial urinary sphincters (AUSs) have a 2.2%–15.5% erosion rate as reported in large case series.1–3 Bladder neck cuffs in women and membranous sphincter cuffs in men require a retropubic dissection for removal. We report a series of eight patients who underwent removal of their grossly eroded membranous AUS cuff through a total endoscopic approach. Materials and Methods: Preoperatively, a noncontrast CT scan is necessary to identify orientation of cuff and tubing. Materials required include a general procedures tray, 24F offset cystoscope (Storz®), sickle knife, and toothed grasping forceps. A transverse incision is made over the AUS tubing that is divided and clipped with artery forceps. A cystoscopy is performed to identify the eroded AUS cuff. The sickle knife is passed through the offset cystoscope and the cuff is cut where visible. A useful tip is to pass behind the cuff and lift into the urethra to cut the backing mesh if possible. Once cut, we use the grasping forceps to...
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