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KMID : 1240020190230030219
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International Neurourology Journal
2019 Volume.23 No. 3 p.219 ~ p.225
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Artificial Urinary Sphincter Cuff Size Predicts Outcome in Male Patients Treated for Stress Incontinence: Results of a Large Central European Multicenter Cohort Study
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Queissert Fabian
Huesch Tanja
Kretschmer Alexander
Anding Ralf
Kurosch Martin
Kirschner-Hermanns Ruth
Pottek Tobias
Olianas Roberto
Friedl Alexander
Pfitzenmaier Jesco
Naumann Carsten M.
Wotzka Carola
Nyarangi-Dix Joanne
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Abstract
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Purpose: The aim was to study the correlation between cuff size and outcome after implantation of an AMS 800 artificial urinary sphincter.
Methods: A total of 473 male patients with an AMS 800 sphincter implanted between 2012 and 2014 were analyzed in a retrospective multicenter cohort study performed as part of the Central European Debates on Male Incontinence (DOMINO) Project.
Results: Single cuffs were implanted in 54.5% and double cuffs in 45.5% of the patients. The cuffs used had a median circumference of 4.5 cm. Within a median follow of 18 months, urethral erosion occurred in 12.8% of the cases and was associated significantly more often with small cuff sizes (P<0.001). Multivariate analysis showed that, apart from cuff size (P=0.03), prior irradiation (P<0.001) and the penoscrotal approach (P=0.036) were associated with an increased erosion rate. Continence rate tended to be highest with median cuff sizes (4?5.5 cm).
Conclusions: Apart from irradiation and the penoscrotal approach, small cuff size is a risk factor for urethral erosion. Results are best with cuff sizes of 4.5?5.5 cm.
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KEYWORD
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Artificial urinary sphincter, AMS 800, Cuff size, Male, Stress urinary incontinence, Single or double cuff
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