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Long-term lower urinary tract sequelae following AUS cuff erosion.
Chertack, Nathan A; Caldwell, Kelly M; Joice, Gregory A; Kavoussi, Mehraban; Dropkin, Benjamin M; Ortiz, Nicolas M; Baumgarten, Adam S; Shakir, Nabeel A; Sanders, Sarah C; Hudak, Steven J; Morey, Allen F.
Afiliación
  • Chertack NA; Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
  • Caldwell KM; Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
  • Joice GA; Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
  • Kavoussi M; Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
  • Dropkin BM; Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
  • Ortiz NM; Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
  • Baumgarten AS; Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
  • Shakir NA; Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
  • Sanders SC; Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
  • Hudak SJ; Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
  • Morey AF; Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Neurourol Urodyn ; 41(1): 229-236, 2022 01.
Article en En | MEDLINE | ID: mdl-34559913
AIMS: To examine the rate of lower urinary tract complications (LUTC) and urinary diversion (UD) after artificial urinary sphincter (AUS) explantation with the acute reconstruction of AUS cuff erosion defects. METHODS: We performed a retrospective study of patients who underwent in-situ urethroplasty (ISU) for AUS cuff erosion from June 2007 to December 2020. Outcomes included LUTC (urethral stricture, diverticulum, fistula), AUS reimplantation, and UD. Defect size was prospectively estimated acutely and a subanalysis was performed to determine the impact of erosion severity (small erosions [<33% circumferential defect] and large erosions [≥33%]) on these outcomes. Kaplan-Meier curves were created to compare survival between the two groups. RESULTS: A total of 40 patients underwent ISU for urethral cuff erosion. The median patient age was 76 years old with a median erosion circumference of 46%. The overall LUTC rate was 30% (12/40) with 35% (14/40) of patients requiring permanent UD. Secondary AUS placement occurred in 24/40 (60%) patients with 11/24 (46%) leading to repeat erosion. On subanalysis, small erosion was associated with improved LUTC-free and UD-free survival but not associated with AUS reimplantation. CONCLUSIONS: Lower urinary tract complications are common after AUS cuff erosion and can lead to the need for permanent UD. Patients with larger erosions are more likely to undergo UD and reach this end-stage condition earlier compared to patients with small erosions.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Estrechez Uretral / Incontinencia Urinaria de Esfuerzo / Esfínter Urinario Artificial Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Aged / Humans / Male Idioma: En Revista: Neurourol Urodyn Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Estrechez Uretral / Incontinencia Urinaria de Esfuerzo / Esfínter Urinario Artificial Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Aged / Humans / Male Idioma: En Revista: Neurourol Urodyn Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos