You have accessJournal of UrologyTrauma/Reconstruction: Ureter, Bladder, External Genitalia and Urotrauma II1 Apr 2015MP29-08 INDICATIONS AND TIMING OF REVISION SURGERY IN PATIENTS HAVING HAD MULTIPLE ARTIFICIAL URINARY SPHINCTERS Anastasia Frost, Simon Bugeja, Daniela Andrich, and Anthony Mundy Anastasia FrostAnastasia Frost More articles by this author , Simon BugejaSimon Bugeja More articles by this author , Daniela AndrichDaniela Andrich More articles by this author , and Anthony MundyAnthony Mundy More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.611AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Many patients with an artificial urinary sphincter (AUS) go on to have one or more revisions/replacements over the course of their life. We carried out a retrospective study to evaluate how long the device lasts before it needs to be revised and whether this is reduced with each subsequent implant. METHODS 469 patients underwent AUS implantation in a single unit between April 1982 and June 2013. There were 380 males and 89 females, (age 4.3-84.7 years). Those who went on to have more than one sphincter were identified and evaluated. RESULTS Of 469 patients, 211 (45%) had the AUS explanted after a mean of 5.62 years (range 23 days – 30.5 years). The devices were removed due to malfunction in 47.9% at a mean of 7 years (range 116 days – 30.5 years), erosion in 44.1% at a mean of 4.7 years (29 days – 26.4 years), and infection in 6.6% at a mean time of 1.3 years (23 days – 5.3 years). 149 patients (71%) went on to have a second device implanted. 46 (30.1%) had it removed after a mean of 4.01 years (range 42 days – 17 years). In these, erosion was the commonest cause, occurring on average 4.1 years after implantation. 25 patients had a third sphincter inserted. Of these, 7(28%) were explanted, most commonly due to malfunction (57%). In this group the mean time to explantation was 2.8 years. 6 patients had a fourth device, of which 2(33%) were explanted after 0.6 years and 3.2 years for malfunction and erosion respectively. One patient went on to have a fifth sphincter which was explanted following erosion at 1.9 years. CONCLUSIONS Replacement/revision AUS surgery is feasible. The complication rate associated with successive implantations is more or less similar, ranging between 28 and 33%. However, when complications do arise, they will occur earlier with each subsequent sphincter. This is important when counselling patients who have had multiple previous failed artificial sphincters and are being considered for even further revision surgery. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e342 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Anastasia Frost More articles by this author Simon Bugeja More articles by this author Daniela Andrich More articles by this author Anthony Mundy More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...