Skip to main content
Top
Published in: Current Urology Reports 5/2021

01-05-2021 | Stress Incontinence | Men's Health (R Carrion, Section Editor)

Artificial Urinary Sphincter Complications: Risk Factors, Workup, and Clinical Approach

Authors: Roger K. Khouri Jr, Nicolas M. Ortiz, Benjamin M. Dropkin, Gregory A. Joice, Adam S. Baumgarten, Allen F. Morey, Steven J. Hudak

Published in: Current Urology Reports | Issue 5/2021

Login to get access

Abstract

Purpose of Review

To review risk factors for AUS complications and present a systematic approach to their diagnosis and management.

Recent Findings

Established risk factors for AUS complications include catheterization, channel TURP, pelvic radiation, urethroplasty, anticoagulation, cardiovascular disease, diabetes mellitus, frailty index, hypertension, low albumin, and low testosterone. We present our algorithm for diagnosis and management of AUS complications.

Summary

Despite being the gold standard of treatment for men with SUI, major and minor complications can occur at any point after AUS insertion. Careful consideration of the urologic, medical, and operative risk factors for each patient can help prevent complications. A systematic approach to early and late complications facilitates their identification and effective management. The evaluating urologist must have a thorough understanding of potential AUS complications in order to restore quality of life in men with bothersome SUI.
Literature
4.
8.
go back to reference Averbeck MA, Woodhouse C, Comiter C, Bruschini H, Hanus T, Herschorn S, et al. Surgical treatment of post-prostatectomy stress urinary incontinence in adult men: report from the 6th International Consultation on Incontinence. Neurourol Urodyn. 2019;38(1):398–406. https://doi.org/10.1002/nau.23845.CrossRefPubMed Averbeck MA, Woodhouse C, Comiter C, Bruschini H, Hanus T, Herschorn S, et al. Surgical treatment of post-prostatectomy stress urinary incontinence in adult men: report from the 6th International Consultation on Incontinence. Neurourol Urodyn. 2019;38(1):398–406. https://​doi.​org/​10.​1002/​nau.​23845.CrossRefPubMed
46.
go back to reference Kim M, Choi D, Hong JH, Kim C-S, Ahn H, Choo M-S. Factors contributing to treatment outcomes of post-prostatectomy incontinence surgery for the selection of the proper surgical procedure for individual patients: a single-center experience. Neurourol Urodyn. 2018;37(6):1978–87. https://doi.org/10.1002/nau.23543.CrossRefPubMed Kim M, Choi D, Hong JH, Kim C-S, Ahn H, Choo M-S. Factors contributing to treatment outcomes of post-prostatectomy incontinence surgery for the selection of the proper surgical procedure for individual patients: a single-center experience. Neurourol Urodyn. 2018;37(6):1978–87. https://​doi.​org/​10.​1002/​nau.​23543.CrossRefPubMed
92.
go back to reference Wiedemann L, Cornu J-N, Haab E, Peyrat L, Beley S, Cathelineau X, et al. Transcorporal artificial urinary sphincter implantation as a salvage surgical procedure for challenging cases of male stress urinary incontinence: surgical technique and functional outcomes in a contemporary series. BJU Int. 2013;112(8):1163–8. https://doi.org/10.1111/bju.12386.CrossRefPubMed Wiedemann L, Cornu J-N, Haab E, Peyrat L, Beley S, Cathelineau X, et al. Transcorporal artificial urinary sphincter implantation as a salvage surgical procedure for challenging cases of male stress urinary incontinence: surgical technique and functional outcomes in a contemporary series. BJU Int. 2013;112(8):1163–8. https://​doi.​org/​10.​1111/​bju.​12386.CrossRefPubMed
94.
go back to reference •• Ortiz NM, Wolfe AR, Baumgarten AS, et al. Artificial urinary sphincter cuff erosion “Heat Map” shows similar anatomic characteristics for transcorporal and standard approach. J Urol. 2020. https://doi.org/10.1097/JU.0000000000001148Demonstrates the lack of evidence to support transcorporal AUS placement. •• Ortiz NM, Wolfe AR, Baumgarten AS, et al. Artificial urinary sphincter cuff erosion “Heat Map” shows similar anatomic characteristics for transcorporal and standard approach. J Urol. 2020. https://​doi.​org/​10.​1097/​JU.​0000000000001148​Demonstrates the lack of evidence to support transcorporal AUS placement.
96.
go back to reference Maurer V, Marks P, Dahlem R, Rosenbaum CM, Meyer CP, Riechardt S, et al. Functional outcomes of artificial urinary sphincter implantation with distal bulbar double cuff in men with and without a history of external beam radiotherapy: an analysis of a prospective database. BJU Int. 2019;124(6):1040–6. https://doi.org/10.1111/bju.14882.CrossRefPubMed Maurer V, Marks P, Dahlem R, Rosenbaum CM, Meyer CP, Riechardt S, et al. Functional outcomes of artificial urinary sphincter implantation with distal bulbar double cuff in men with and without a history of external beam radiotherapy: an analysis of a prospective database. BJU Int. 2019;124(6):1040–6. https://​doi.​org/​10.​1111/​bju.​14882.CrossRefPubMed
98.
Metadata
Title
Artificial Urinary Sphincter Complications: Risk Factors, Workup, and Clinical Approach
Authors
Roger K. Khouri Jr
Nicolas M. Ortiz
Benjamin M. Dropkin
Gregory A. Joice
Adam S. Baumgarten
Allen F. Morey
Steven J. Hudak
Publication date
01-05-2021
Publisher
Springer US
Published in
Current Urology Reports / Issue 5/2021
Print ISSN: 1527-2737
Electronic ISSN: 1534-6285
DOI
https://doi.org/10.1007/s11934-021-01045-x