PD49-04 INCREASED AUS RESERVOIR VOLUMES DO NOT CORRELATE WITH INCREASED PRESSURE DELIVERY

Abstract

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Male Incontinence: Therapy II1 Apr 2016PD49-04 INCREASED AUS RESERVOIR VOLUMES DO NOT CORRELATE WITH INCREASED PRESSURE DELIVERY Katie Cunningham and O. Lenaine Westney Katie CunninghamKatie Cunningham More articles by this author and O. Lenaine WestneyO. Lenaine Westney More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2740AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The artificial urinary sphincter is the gold standard for the treatment of postprostatectomy incontinence. The 3-component AMS 800TM system includes a pressure regulating balloon (PRB), silicone urethral cuff and a control pump with associated tubing. The PRB is filled intra-operatively with 0.9% normal saline or an isotonic contrast mixture, delivers the occlusive force to the urethral cuff. Though the PRB has been available in a variety of 10 cm H2O pressure ranges from 41-100 cm H2O, the 61-70 cm H2O balloon is the most commonly utilized. The properties of the PRB – wall thickness, elasticity of the material (silicone elastomer) and the volume – are responsible for the resultant delivery pressure. According to the manufacturer’s device description, the pressure within the PRB is maintained within a certain range when a specific fluid volume is injected into the balloon. Anecdotally, urologists have increased the volume in the PRB in certain situations to accommodate the fluid requirements of a larger cuff or based on a hypothesis of augmenting the occlusive force. However, the effects of increasing volume in the PRB have not been objectively evaluated. The purpose of our study was to evaluate the pressure delivered by the AMS 800TM 61-70 cm H2O PRB at different volumes. METHODS We performed ex-vivo testing of two 61-70cmH20 pressure regulating balloons. The pressure transmitted by the PRB was measured at pre-designated volumetric intervals using a GE Dash 4000TM Vital Signs Monitor and an arterial line pressure transducer. After prepping the component, the PRB’s were sequentially filled with 20, 23, 25, 30 and 40 ccs of normal saline. Subsequently, we continued to test a single PRB from 50 cc to 100 cc of volume, recording the pressure at 10 cc increments. RESULTS Both 61-70 cm H2O PRB’s maintained stable pressures from 20-25 ccs. Recorded pressure transmission at 30-40 cc, while still in range, was reduced. Further PRB expansion resulted in the transduced pressure progressively dropping then going below the manufacturer’s specified range at volumes > 60cc (Figure 1). CONCLUSIONS The pressure delivery characteristics of the AMS 800 TM PRB allow for maintenance of the prescribed range up to a volume of 25cc. Filling of the PRB in a compliant space above that volume results in a drop of transmitted pressure rather than an increase. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e1181-e1182 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Katie Cunningham More articles by this author O. Lenaine Westney More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...