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Proximal artificial sphincter cuff repositioning for urethral atrophy incontinence
D R Couillard1, J M Vapnek, A R Stone
1Department of Urology, University of California, Davis, Sacramento, USA.
Urology
|April 1, 1995
Summary
Proximal repositioning of the artificial urinary sphincter (AUS) cuff is a safe and effective treatment for recurrent incontinence caused by urethral atrophy. This technique offers significant improvement for most patients, minimizing erosion risks.
Area of Science:
- Urology
- Andrology
- Reconstructive Surgery
Background:
- Recurrent incontinence after artificial urinary sphincter (AUS) implantation can stem from urethral atrophy.
- Current treatment options like cuff size reduction or increased balloon pressure carry risks such as erosion or limited efficacy.
- Proximal cuff repositioning presents an alternative management strategy.
Purpose of the Study:
- To evaluate the safety, simplicity, and effectiveness of proximal cuff repositioning for recurrent incontinence due to urethral atrophy.
- To demonstrate this technique as a viable solution for loss of cuff compression.
Main Methods:
- Six patients with recurrent post-prostatectomy incontinence underwent proximal repositioning of the artificial urinary sphincter (AS-800) cuff.
- Urethral atrophy was systematically evaluated prior to the procedure.
- The surgical technique for proximal repositioning was detailed.
Main Results:
- Eighty-three percent (5 out of 6) of patients experienced significant improvement in incontinence.
- The average follow-up period exceeded one year.
- One patient showed no improvement, linked to poor detrusor compliance and sphincter weakness.
Conclusions:
- Proximal cuff repositioning on the bulbar urethra is an effective and safe method for managing recurrent incontinence.
- This technique addresses urethral atrophy and the resulting loss of cuff compression.
- It offers a simpler approach with a potentially minimized risk of erosion compared to other interventions.