Related Experiment Video
Updated: Oct 1, 2025
03:25
Transcorporal Artificial Urinary Sphincter Cuff Placement in a Case Requiring Revision for Urethral Atrophy
Published on: June 16, 2022
999
Risk Factors for Revision After Artificial Urinary Sphincter Implantation in Male Patients With Stress Urinary
Celeste Manfredi1, Pramod Krishnappa2, Esaú Fernández-Pascual3,4
1Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy.
International Neurourology Journal
|March 8, 2022
Summary
Revision after artificial urinary sphincter (AUS) implantation for stress urinary incontinence (SUI) is predicted by vesicourethral anastomosis stenosis and urethral cuff size. These factors also impact long-term AUS survival.
Area of Science:
- Urology
- Surgical Innovation
- Medical Device Engineering
Background:
- Stress urinary incontinence (SUI) significantly impacts quality of life in men.
- Artificial urinary sphincter (AUS) implantation is a common treatment for moderate-to-severe SUI.
- Understanding revision predictors is crucial for improving AUS outcomes.
Purpose of the Study:
- To identify preoperative and intraoperative risk factors for revision surgery after AUS implantation.
- To analyze causes and timing of revision in patients with SUI.
Main Methods:
- Retrospective analysis of a prospectively maintained database of male patients undergoing AMS 800 AUS implantation.
- Multivariable logistic regression and competing risk analysis (Fine-Gray model) were used to identify risk factors.
- Data on revision causes, types, and time to revision were collected.
Main Results:
- 31.4% of 70 patients required revision surgery, with a median time of 26.5 months.
- Mechanical dysfunction (50.0%) and urethral erosion (27.3%) were primary revision causes.
- Vesicourethral anastomosis stenosis (P=0.02), urethral cuff size of 3.5 cm (P=0.029), and dual implantation (P=0.048) independently predicted revision.
- Vesicourethral anastomosis stenosis and 3.5 cm cuff size predicted lower AUS survival.
Conclusions:
- Vesicourethral anastomosis stenosis, 3.5 cm urethral cuff size, and dual implantation are key predictors for AUS revision.
- Vesicourethral anastomosis stenosis and 3.5 cm urethral cuff size specifically correlate with reduced AUS device survival.
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