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Risk factors for erosion of artificial urinary sphincters: a multicenter prospective study
Journal article   Open access   Peer reviewed

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 III and Joshua A Broghammer
Urology (Ridgewood, N.J.), Vol.84(4), pp.934-939
10/2014
DOI: 10.1016/j.urology.2014.05.043
PMCID: PMC4307589
PMID: 25109562
url
https://doi.org/10.1016/j.urology.2014.05.043View
Published (Version of record) Open Access

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Abstract

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. 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. 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. 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.
Prospective Studies Prosthesis Failure Follow-Up Studies Humans Risk Factors Aged Urinary Sphincter, Artificial - adverse effects

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