Risk factors for erosion of artificial urinary sphincters: A multicenter prospective study

William O. Brant, Bradley A. Erickson, Sean P. Elliott, Christopher Powell, Nejd Alsikafi, Christopher McClung, Jeremy B. Myers, Bryan B. Voelzke, Thomas G. Smith, Joshua A. Broghammer

Research output: Contribution to journalArticlepeer-review

103 Scopus citations

Abstract

Objective To evaluate the short- to medium-term outcomes after artificial urinary sphincter (AUS) placement from a large, multi-institutional, prospective, follow-up study. We hypothesize that along with radiation, patients with any history of a direct surgery to the urethra will have higher rates of eventual AUS explantation for erosion and/or infection. Materials and Methods A prospective outcome analysis was performed on 386 patients treated with AUS placement from April 2009 to December 2012 at 8 institutions with at least 3 months of follow-up. Charts were analyzed for preoperative risk factors and postoperative complications requiring explantation. Results Approximately 50% of patients were considered high risk. High risk was defined as patients having undergone radiation therapy, urethroplasty, multiple treatments for bladder neck contracture or urethral stricture, urethral stent placement, or a history of erosion or infection in a previous AUS. A total of 31 explantations (8.03%) were performed during the follow-up period. Overall explantation rates were higher in those with prior radiation and prior UroLume. Men with prior AUS infection or erosion also had a trend for higher rates of subsequent explantation. Men receiving 3.5-cm cuffs had significantly higher explantation rates than those receiving larger cuffs. Conclusion This outcomes study confirms that urethral risk factors, including radiation history, prior AUS erosion, and a history of urethral stent placement, increase the risk of AUS explantation in short-term follow-up.

Original languageEnglish (US)
Pages (from-to)934-939
Number of pages6
JournalUrology
Volume84
Issue number4
DOIs
StatePublished - Oct 1 2014

Bibliographical note

Funding Information:
Funding Support: The funding source for this work is an unrestricted research grant to Dr. Brant from the Joe W. and Dorothy Dorsett Brown Foundation . There are no commercial sources of funding.

Funding Information:
Financial Disclosure: William O. Brant is a consultant, proctor, meeting participant, and a grant recipient of American Medical Systems , a consultant and proctor in Coloplast, and a member of the Speaker's Bureau in Auxilium. Sean Elliott is a consultant in American Medical Systems and GT Urological, a grant recipient of Auxilium , and holds a leadership position in PercuVision. Nejd Alsikafi is a consultant in American Medical Systems. Jeremy Myers holds an unpaid leadership position in the International Volunteers in Urology. Joshua Broghammer is a consultant and proctor in American Medical Systems. The remaining authors declare that they have no relevant financial interests.

Publisher Copyright:
© 2014 Elsevier Inc. All rights reserved.

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