V07-02 URETHRAL BULKING WITH NATIVE TISSUE FOR FRAIL URETHRAS DURING ARTIFICIAL URINARY SPHINCTER SURGERY

Abstract

You have accessJournal of UrologyCME1 Apr 2023V07-02 URETHRAL BULKING WITH NATIVE TISSUE FOR FRAIL URETHRAS DURING ARTIFICIAL URINARY SPHINCTER SURGERY William Du Comb, Nora Haney, Matthew Rabinowitz, James Liu, and Arthur Burnett William Du CombWilliam Du Comb More articles by this author , Nora HaneyNora Haney More articles by this author , Matthew RabinowitzMatthew Rabinowitz More articles by this author , James LiuJames Liu More articles by this author , and Arthur BurnettArthur Burnett More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003288.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The artificial urinary sphincter (AUS) has long been the ideal surgical treatment option for men with stress urinary incontinence (SUI) and has excellent patient satisfaction rates. However, revision rates remain as high as 50%. We describe our use of native periurethral tissue as a urethral bulking technique in patients with frail urethras during AUS surgery. METHODS: An AUS is inserted or revised in the usual standard fashion. The state of the urethral tissue is inspected, and the circumference is measured. When the urethral circumference is less than 4 cm or the urethral tissue is frail, periurethral tissue bulking is performed. Dissection of the bulbospongiosus muscle is carried out at the level of the bulbar urethra, incorporating it with a circumferential measurement. In the event the bulbospongiosus muscle is inadequate for bulking, the proximal corpus spongiosum is mobilized distally as a ventral flap, beneath the circumferential measurement. The AUS size is then selected. RESULTS: Using native periurethral tissue for urethral bulking can add up to 1 cm in cuff size when placing an AUS in patients with frail urethras. Patient satisfaction rates remain high, and there has been no documented device erosion with our technique. CONCLUSIONS: We have demonstrated an alternative approach to urethral bulking with native periurethral tissue in patients undergoing AUS placement who are found to have frail urethras. Urethral bulking with native tissue provides a durable alternative to transcorporal cuff placement or tandem cuffs to establish proper coaptation. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e596 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information William Du Comb More articles by this author Nora Haney More articles by this author Matthew Rabinowitz More articles by this author James Liu More articles by this author Arthur Burnett More articles by this author Expand All Advertisement PDF downloadLoading ...