V02-08 ARTIFICIAL URINARY SPHINCTER CUFF MODIFICATION AND OTHER “TRICKS OF THE TRADE”

Abstract

You have accessJournal of UrologyCME1 May 2022V02-08 ARTIFICIAL URINARY SPHINCTER CUFF MODIFICATION AND OTHER “TRICKS OF THE TRADE” Jane Kurtzman, Preston Kerr, and Steven Brandes Jane KurtzmanJane Kurtzman More articles by this author , Preston KerrPreston Kerr More articles by this author , and Steven BrandesSteven Brandes More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002528.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The Artificial Urethral Sphincter (AUS) is the gold standard for stress urinary incontinence (SUI). The AMS 800 AUS is the most widely used device and has well over a 30-year track record of excellent efficacy and durability. We describe tips for AUS placement and advanced troubleshooting for when you run into problems. METHODS: Proper placement of an AUS requires no bulbospongiosus muscle on the urethra. We utilize a split and roll to ensure a 2cm plane for the AUS. Prior to pump placement we cycle the AUS pump 5-10x for easier activation. We create a “Fuse Box” for future troubleshooting. in cases of mis-sizing an AUS cuff, we modify our cuff via a incision into the cuff and a carefully placed 4-0 prolene. Our technique for troubleshooting an AUS starts with assessing for pressure regulating balloon (PRB) fatigue. RESULTS: Use of our techniques has resulted in an excellent success record for AUS placement. Use of our cuff modification technique has shown no difference in survival or adverse events as a result of the modification. CONCLUSIONS: A properly placed and sized AUS is the gold standard for SUI. Principles for a successful placement of an AUS includes use of the Split and Roll technique, cycling the pump 5-10x prior to placement, creation of a “Fuse Box,” and salvaging an improperly sized cuff through use of our modification technique. During troubleshooting always check the PRB first. Source of Funding: NA © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e113 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jane Kurtzman More articles by this author Preston Kerr More articles by this author Steven Brandes More articles by this author Expand All Advertisement PDF DownloadLoading ...