Unusual Cause of Artificial Urinary Sphincter Malfunction: Device Entanglement Resulting in Urethral Constriction and Urinary Retention

Urinary retention following placement of an artificial urinary sphincter (AUS) is not an uncommon complication. We describe a unique case of urinary retention due to AUS entanglement causing urethral constriction in a 72-year-old male. He presented to the emergency department postoperatively following AUS placement with pelvic pain and incomplete emptying. Eventual cystourethroscopy demonstrated severe extrinsic urethral constriction despite the deactivation of the AUS device. Surgical exploration revealed an unexpected looping of the occlusive cuff, causing urethral constriction. Although the precise cause is not clearly known, we suspect that it may have been related to the process of connecting the tubing at the level of the abdomen. Regardless of the underlying etiology, this case highlights a unique complication and supports an assessment of the cuff with direct perineal inspection prior to wound closure and/or with cystourethroscopy.