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Related Experiment Videos

A User's Guide for Surgery Involving the Artificial Urinary Sphincter.

Jyoti D Chouhan1, Ryan P Terlecki1

  • 1Department of Urology, Wake Forest Baptist Medical Center, Winston-Salem, NC, USA.

Sexual Medicine Reviews
|December 5, 2018
PubMed
Summary

The artificial urinary sphincter (AUS) is effective for male stress urinary incontinence (SUI). Proper patient selection and surgical technique are key to successful outcomes and managing recurrent SUI.

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Editorial Comment.

Urology practice·2023

Area of Science:

  • Urology
  • Surgical Innovation

Background:

  • The artificial urinary sphincter (AUS) is the gold standard for surgical correction of male stress urinary incontinence (SUI).
  • While initial success rates are high, long-term durability can decline, necessitating revision surgery.

Purpose of the Study:

  • To review existing data and clinical experience on patient selection, surgical technique, and postoperative management of the AUS.
  • To provide guidance for optimizing outcomes and addressing challenges associated with AUS implantation.

Main Methods:

  • A systematic review of peer-reviewed literature was conducted.
  • Contemporary articles on perioperative and long-term AUS management were identified.
  • Clinical experience of the senior author was incorporated.
Keywords:
ArtificialProstheses and ImplantsStressTreatment OutcomeUrethraUrinary IncontinenceUrinary Sphincter

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Main Results:

  • Preoperative screening, including cystoscopy, is crucial for identifying bladder neck contracture.
  • Perineal cuff placement is associated with better outcomes.
  • Prior radiation and specific cuff size (3.5-cm) are risk factors for urethral erosion.
  • Recurrent SUI may be caused by restrictive encapsulation, impacting revision surgery strategies.

Conclusions:

  • The AUS remains an excellent option for moderate to severe male SUI.
  • Meticulous preoperative evaluation and patient selection are critical for success.
  • Recurrent SUI after AUS can be managed effectively with a structured approach.