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Radiographic imaging of the artificial urinary sphincter pressure regulating balloon
S P Petrou1, J R Williams HJ, P R Young
1Department of Urology, Mayo Clinic Jacksonville, Jacksonville, Florida 32224, USA.
The Journal of Urology
|May 9, 2001
Summary
Radiographs of artificial urinary sphincter balloons are crucial for evaluating incontinence. Detecting volume loss requires comparison with a baseline image, as changes are missed until at least 50% of the contrast solution is lost.
Area of Science:
- Urology
- Radiology
- Medical Imaging
Background:
- Artificial urinary sphincter (AUS) radiography is used for postoperative evaluation of recurrent incontinence.
- Assessing the pressure regulating balloon (PRB) component of the AUS is vital for device function.
Purpose of the Study:
- To investigate the ability of urologists and radiologists to detect radiographic changes in the AUS PRB at varying contrast solution volumes.
- To determine the sensitivity of radiographic assessment for PRB volume loss.
Main Methods:
- Sequential radiographs of a PRB in a body phantom were obtained, with contrast volume decreasing by 1 cc per image.
- Urologists and radiologists reviewed radiographs for changes in balloon size, density, and circularity, both independently and with side-by-side comparison to a baseline.
Main Results:
- On side-by-side comparison, changes in size, density, and circularity were detected at 17, 13, and 8 cc, respectively.
- In independent review, changes were detected at 10, 8, and 6 cc for size, density, and circularity, respectively.
- Significant volume loss (over 50%) can go undetected without a baseline radiograph.
Conclusions:
- Contrast solution should be used in the AUS PRB component when feasible.
- A baseline radiograph immediately after AUS implantation is essential for accurate postoperative monitoring.
- Comparison imaging is invaluable for detecting PRB volume loss, highlighting the importance of immediate post-placement radiographs.