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Natural History of Artificial Urinary Sphincter Erosion: Long-term Lower Urinary Tract Outcomes and Incontinence Management.
Findlay, Bridget L; Fadel, Anthony; Pence, Sierra T; Britton, Cameron J; Linder, Brian J; Elliott, Daniel S.
Afiliación
  • Findlay BL; Department of Urology, Mayo Clinic, Rochester, MN.
  • Fadel A; Department of Urology, Mayo Clinic, Rochester, MN.
  • Pence ST; Department of Urology, Mayo Clinic, Rochester, MN.
  • Britton CJ; Department of Urology, Mayo Clinic, Rochester, MN.
  • Linder BJ; Department of Urology, Mayo Clinic, Rochester, MN.
  • Elliott DS; Department of Urology, Mayo Clinic, Rochester, MN. Electronic address: Elliott.daniel@mayo.edu.
Urology ; 2024 Jun 27.
Article en En | MEDLINE | ID: mdl-38944387
ABSTRACT

OBJECTIVE:

To describe long-term lower urinary tract outcomes and incontinence management after AUS erosion, including risk factors associated with each outcome.

METHODS:

We retrospectively reviewed our prospectively maintained AUS database for men undergoing device explantation for urethral erosion from January 1, 1986 to October 10, 2023. Outcomes included development of urethral stricture and management of post-explant incontinence (eg, pads/clamp, catheter, salvage AUS, supravesical diversion). Risk factors were tested for association with stricture formation and repeat AUS erosion using logistic regression.

RESULTS:

Around 1943 unique patients underwent AUS implantation during the study period, and 217 (11%) had a device explantation for urethral erosion. Of these, 194 had complete records available and were included for analysis. Median follow-up from implantation was 7.5 years (IQR 2.7-13.7) and median time to erosion was 2 yrs (IQR 0-6). Ninety-six patients (49%) underwent salvage AUS placement. Of those, 38/96 (40%) were explanted for subsequent erosion. On multivariable analysis, no factors were significantly associated with risk of salvage AUS erosion. On multivariable model, pelvic radiation (OR 2.7; 95% CI 1.0-7.4) and urethral reapproximation during explant for erosion (OR 4.2; 95% CI 1.5-11.2) were significantly associated with increased risk of urethral stricture (P <.05). At the time of last follow-up, 69/194 (36%) patients had a functioning salvage AUS, including both initial and subsequent salvage implants.

CONCLUSION:

Following AUS erosion, radiation history and urethral reapproximation at explantation were risk factors for development of urethral stricture. Salvage AUS replacement can be performed, but has a higher rate of repeat urethral erosion.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Urology Año: 2024 Tipo del documento: Article País de afiliación: Mongolia Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Urology Año: 2024 Tipo del documento: Article País de afiliación: Mongolia Pais de publicación: Estados Unidos