MP88-15 LOCATION OF AUS PRESSURE REGULATING BALLOON: FUNCTIONAL OUTCOMES OF HIGH SUBMUSCULAR POSITION ARE EQUIVALENT TO SPACE OF RETZIUS

Abstract

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Male Incontinence: Therapy1 Apr 2015MP88-15 LOCATION OF AUS PRESSURE REGULATING BALLOON: FUNCTIONAL OUTCOMES OF HIGH SUBMUSCULAR POSITION ARE EQUIVALENT TO SPACE OF RETZIUS Nirmish Singla, Jay Simhan, Jordan Siegel, Timothy Tausch, and Allen Morey Nirmish SinglaNirmish Singla More articles by this author , Jay SimhanJay Simhan More articles by this author , Jordan SiegelJordan Siegel More articles by this author , Timothy TauschTimothy Tausch More articles by this author , and Allen MoreyAllen Morey More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1848AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Traditional placement of artificial urinary sphincter (AUS) pressure regulating balloons (PRB) within the space of Retzius (SOR) may be challenging and subject to troublesome complications. We report our longitudinal experience utilizing a novel high submuscular (HSM) PRB placement technique and compare functional outcomes to traditional SOR placement of the PRB. METHODS We reviewed a prospectively maintained database of AUS patients between July 2007 and January 2014. Only 61-70 cm H2O PRBs were placed through a trans-scrotal approach via an HSM tunnel (2011-2014) or within the SOR (2007-2010). Our HSM technique consisted of uniform placement of the PRB beneath the rectus abdominis muscle while SOR placement involved perforation of the transversalis fascia at the pubic tubercle, beneath the external inguinal ring. Demographics, patient data, cuff durability, and functional outcomes were compared between groups. RESULTS 232 consecutive patients underwent AUS placement with a mean follow up of 38 months. SOR placement was performed in 139 (60%) patients while HSM placement was performed in 93 (40%). Functional outcomes including continence (defined as 0-1 pads/day) rates (88% vs. 81%, p=0.15), erosion rates (9% vs. 5%, p=0.32), and explantation rates (12% vs. 10%, p=0.83) were similar between groups. Fewer AUS revisions for persistent incontinence were required in patients undergoing HSM PRB placement (6.5% vs. 18%, p=0.01). Although mean follow-up was longer for patients undergoing SOR placement (51 vs. 20 months, p<0.001), Kaplan-Meier analysis revealed no difference between groups with regards to rates of explantation (p=0.71) or revision (p=0.36). CONCLUSIONS High submuscular placement of the PRB at the time of AUS surgery offers a safe and effective alternative with equivalent functional outcomes to traditional SOR. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e1097-e1098 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Nirmish Singla More articles by this author Jay Simhan More articles by this author Jordan Siegel More articles by this author Timothy Tausch More articles by this author Allen Morey More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...