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Updated: Dec 28, 2025
03:25
Transcorporal Artificial Urinary Sphincter Cuff Placement in a Case Requiring Revision for Urethral Atrophy
Published on: June 16, 2022
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Pressure Regulating Balloon Herniation: A Correctable Cause of Artificial Urinary Sphincter Malfunction
Roger K Khouri1, Adam S Baumgarten1, Nicolas M Ortiz1
1Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX.
Urology
|February 15, 2020
Summary
Replacing a herniated pressure regulating balloon (PRB) in artificial urinary sphincter (AUS) devices is a safe and effective treatment for persistent incontinence. This salvage therapy significantly improves stress urinary incontinence and achieves continence in most patients.
Area of Science:
- Urology
- Medical Devices
- Surgical Innovation
Background:
- Artificial urinary sphincter (AUS) devices are used to treat urinary incontinence.
- Herniation of the pressure regulating balloon (PRB) is a rare complication of AUS surgery.
- PRB herniation can lead to persistent stress urinary incontinence despite an otherwise functional AUS system.
Purpose of the Study:
- To evaluate the efficacy and safety of isolated pressure regulating balloon (PRB) replacement for artificial urinary sphincter (AUS) malfunction caused by PRB herniation.
- To assess the impact of PRB replacement on stress urinary incontinence and patient continence.
- To determine predictors of successful outcomes in patients undergoing PRB revision.
Main Methods:
- Retrospective review of a single-surgeon male AUS database (2011-2019).
- Analysis of patients with herniated PRBs and persistent stress urinary incontinence, excluding those with AUS fluid loss.
- Isolated PRB replacement in a submuscular location; continence defined as ≤1 pad/day; intraoperative cystoscopy for sphincter coaptation assessment.
Main Results:
- Identified 23 patients (3.2%) with PRB herniation undergoing isolated PRB replacement.
- After excluding 4 patients, 19 patients had a mean follow-up of 21.7 months.
- 94.7% (18/19) reported significant improvement in stress urinary incontinence, and 78.9% (15/19) achieved continence.
Conclusions:
- Isolated PRB replacement is a safe and effective salvage therapy for AUS patients with PRB herniation and persistent incontinence.
- This procedure offers significant improvement in stress urinary incontinence and achieves continence in a majority of patients.
- Intraoperative cystoscopic confirmation of enhanced sphincter coaptation is a reliable predictor of successful treatment outcomes.
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