You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Male Incontinence: Therapy I1 Apr 2018PD26-12 PROSPECTIVE ANALYSIS OF URETHRAL STRICTURE OCCURRENCE AFTER CUFF EROSION WITH AMS ARTIFICIAL SPHINCTER DEVICES Tim Ludwig, Katharina Kuhlencord, Valentin Maurer, Phillip Marks, Clemens Rosenbaum, Oliver Engel, Silke Riechardt, Margit Fisch, and Roland Dahlem Tim LudwigTim Ludwig More articles by this author , Katharina KuhlencordKatharina Kuhlencord More articles by this author , Valentin MaurerValentin Maurer More articles by this author , Phillip MarksPhillip Marks More articles by this author , Clemens RosenbaumClemens Rosenbaum More articles by this author , Oliver EngelOliver Engel More articles by this author , Silke RiechardtSilke Riechardt More articles by this author , Margit FischMargit Fisch More articles by this author , and Roland DahlemRoland Dahlem More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1351AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES AMS implantation is a standard treatment for severe urinary stress incontinence (SUI). Handling of complications, especially complications after cuff erosion remain unclear. Since Rozanski et al. (J. Urol, 2014) and other groups showed high urethral stricture rates after erosion and suggesting a primary urethral reconstruction and we assessed our prospective AMS database to investigate stricture rates after cuff erosion and explantation of the cuff(s). METHODS Since 2009, we prospectively collect data for all patients who undergo AMS 800 implantation due to SUI at our tertiary center. Activation of AUS is performed 6 weeks postoperatively at our institution. Further follow-up (FU) consisting of pad test, maximal urinary flow rate (Qmax), post void residual urine (PVR), radiography, and standardized questionnaire is scheduled 6, 24 months and every two years thereafter. In case of explantation due to cuff erosion c. spongiosus is sutured and a catheter is inserted for 3 weeks. Afterwards radiographic examination is performed to check whether there is some stricture disease. Further FU consisting of maximal urinary flow rate and post voiding residual urine was performed on a regular base. Qmax lower than 10ml/s or a reduction of 25% was suspected a stricture disease and a radiography was performed. In this analysis only patients who underwent a cuff explantation and who were in further treatment of SUI in our department were included. Primary endpoint was urethral stricture rate. RESULTS A total of 24 patients with a mean FU of 18.7 months (IQR 6-23.25) were available for analysis. At baseline mean age was 71 yrs (range 52-87). Within FU 2 Patients (8.3%) suffered from urethral stricture disease. 22 Patients without suspicion for urethral stricture disease showed a median Qmax of 17 ml/s (IQR 15-27 ml/s) and a median PVR of 0 ml (IQR 0-0). CONCLUSIONS At midterm FU we could not proof any urethral stricture rate after cuff explantation justifying a primary repair since the stricture rate is lower as described for primary urethroplasty. We observed lower stricture rate than in published data so far. The different stricture rate observed might be caused by slightly different techniques for implantation and explantation. Cuff explantation without urethral repair seems to be safe and effective without any high risk of urethral stricture disease. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e556 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Tim Ludwig More articles by this author Katharina Kuhlencord More articles by this author Valentin Maurer More articles by this author Phillip Marks More articles by this author Clemens Rosenbaum More articles by this author Oliver Engel More articles by this author Silke Riechardt More articles by this author Margit Fisch More articles by this author Roland Dahlem More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...