V5-07 PERINEAL ARTIFICIAL URINARY SPHINCTER (AUS) WITH HIGH SUBMUSCULAR (HSM) PLACEMENT OF PRESSURE REGULATING BALLOON (PRB)

Abstract

You have accessJournal of UrologyBPH and Voiding Dysfunction1 Apr 2017V5-07 PERINEAL ARTIFICIAL URINARY SPHINCTER (AUS) WITH HIGH SUBMUSCULAR (HSM) PLACEMENT OF PRESSURE REGULATING BALLOON (PRB) Billy Cordon and Allen Morey Billy CordonBilly Cordon More articles by this author and Allen MoreyAllen Morey More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1412AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES In patients undergoing Artificial Urinary Sphincter (AUS) placement, with a history of major pelvic surgery, avoidance of the Space of Retzius with traditional placement of the Pressure Regulating Balloon (PRB) may be beneficial. This video presents perineal AUS placement with high submuscular placement (HSM) of the PRB. METHODS A perineal incision provides excellent exposure of the bulbar urethra for proximal bulbar urethral cuff placement. Via a separate 2cm high scrotal incision the external inguinal ring is identified. A pediatric Deaver is placed within the superficial ring and blunt finger dissection used above the transversalis fascia develops a space below the rectus that accommodates the PRB. Using one's index finger the PRB is then easily placed in the HSM space without any additional instrumentation. Finally through this same incision a subdartos pouch is created for pump placement. The AUS is cycled and deactivated and the wound is closed in multiple layers. RESULTS There is no difference in revision rates between HSM PRB placement versus Space of Retzius placement. CONCLUSIONS HSM placement of the PRB at the time of AUS implantation avoids the Space of Retzius with associated potential bladder, bowel, or vascular injury and/or complications. HSM placement avoids peritoneal placement post-robotic prostatectomy. HSM placement is safe, effective, can easily be learned and implemented, and may be used with concomitant IPP placement. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e601 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Billy Cordon More articles by this author Allen Morey More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...