MP71-01 CIRCUMCORPORAL ARTIFICIAL URINARY SPHINCTER (CC-AUS): A NOVEL SURGICAL APPROACH FOR THE TREATMENT OF COMPLEX MALE STRESS URINARY INCONTINENCE (SUI)

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP71-01 CIRCUMCORPORAL ARTIFICIAL URINARY SPHINCTER (CC-AUS): A NOVEL SURGICAL APPROACH FOR THE TREATMENT OF COMPLEX MALE STRESS URINARY INCONTINENCE (SUI) Jeff Brady, Adam Procunier, Kevin Slagoski, Roshane Perera, Isabella Delbakhsh, and Brandon Foley Jeff BradyJeff Brady More articles by this author , Adam ProcunierAdam Procunier More articles by this author , Kevin SlagoskiKevin Slagoski More articles by this author , Roshane PereraRoshane Perera More articles by this author , Isabella DelbakhshIsabella Delbakhsh More articles by this author , and Brandon FoleyBrandon Foley More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003339.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The CIRCUMCORPORAL AUS (CC-AUS) is an innovative approach for patients with compromised urethras previously not candidates for replacement of an AUS. Men who have had prior AUS erosions, with simultaneously compromised corpora cavernosa, may no longer be suitable candidates for available techniques, such as the transcorporal AUS (TC-AUS). This is a single surgeon (JB) review of the outcomes of the CIRCUMCORPORAL-AUS where the cuff is placed around all three corporal bodies. METHODS: This is a retrospective study on a database of AUS surgical outcomes. From 2000 to present, 611 AUS procedures were performed. Of these, 12 CC-AUS procedures were performed between Feb 2016 and Nov 2022. 10 have had sufficient follow up after AUS activation and are included in the analysis. Of the 7 patients with prostate cancer, all had radiation therapy (XRT). 5 had a radical prostatectomy with adjuvant XRT, 1 had EBRT alone and 1 had XRT with salvage cryoablation. One patient had a traumatic pelvic fracture with a bladder neck injury. The average cuff size was 8.98 cm. Patients were surveyed pre- and post-operatively and scored the severity of their incontinence in pads/day, improvement vs pre-op SUI, comparison to their first AUS and if they would have the surgery again. Outcomes were analyzed using 2 tailed T-test. RESULTS: Mean follow up is 2.5 years (1.3 to 6.5 years). There was a decrease from 9.9 to 3.34 pads/day (p=0.002). 100% of patients noted SUI improvement from pre-op (prior to CC-AUS). When compared to the first AUS, 44% felt they were “more dry”, 11% were similar and 44% felt “less dry”. All patients would have surgery again or would recommend to a friend. No patients reported urinary retention, change in penile sensation, glans necrosis, infections, or AUS malfunction. 2 patients required downsizing of their cuffs, and both had improvement. One patient had an erosion (ventral) of his CC-AUS with removal. CONCLUSIONS: This is the first report of the CIRCUMCORPORAL AUS. It appears to be a safe and effective surgical option for SUI in complex cases with prior AUS erosions. It has been successful in patients following XRT and multiple prior erosions. There have been no sensory or penile vascular changes noted. Longer term follow up is required to determine if results are durable. Source of Funding: N/A © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1013 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jeff Brady More articles by this author Adam Procunier More articles by this author Kevin Slagoski More articles by this author Roshane Perera More articles by this author Isabella Delbakhsh More articles by this author Brandon Foley More articles by this author Expand All Advertisement PDF downloadLoading ...