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08-06-2024 | Special Section: Editor's Invite

Radiologic feature of complications after artificial urinary sphincter implantation following total prostatectomy

Authors: Shioto Oda, Hirofumi Kuno, Takashi Hiyama, Masayuki Yamaguchi, Tomoaki Sasaki, Shugo Yajima, Hitoshi Masuda, Tatsushi Kobayashi

Published in: Abdominal Radiology

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Abstract

Incontinence following total prostatectomy for prostate cancer significantly impairs patient’s quality of life. In severe cases, implantation of an artificial urinary sphincter (AUS) has shown favorable outcomes, enhancing continence by constricting the bulbous urethra. The AUS system consists of a pressure-maintaining balloon, control pump serving as the operational switch, cuff that constricts the urethra, and tubes and connectors that link these components, maintaining a continuous circuit through an internal pressure medium. Most instances of AUS dysfunction are attributed to circuit leaks leading to a reduction in internal pressure, which is identifiable on imaging by fluid accumulation around the circuit, balloon collapse, control pump deformation, and air within the circuit. When the AUS circuit is uncompromised, dysfunction may arise from issues such as the inability to compress the pump due to pain or displacement outside the scrotum or urinary tract obstruction caused by bladder hemorrhage/hematoma. Imaging plays a pivotal role in the evaluation of urinary tract injuries, hematomas/seromas, and infections associated with AUS placement or replacement. Understanding the function of AUS and its appearance on CT imaging is essential for accurately assessing AUS dysfunction and post-implantation complications, guiding clinical decision-making and improving patient care outcomes.

Graphical abstract

Literature
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Metadata
Title
Radiologic feature of complications after artificial urinary sphincter implantation following total prostatectomy
Authors
Shioto Oda
Hirofumi Kuno
Takashi Hiyama
Masayuki Yamaguchi
Tomoaki Sasaki
Shugo Yajima
Hitoshi Masuda
Tatsushi Kobayashi
Publication date
08-06-2024
Publisher
Springer US
Published in
Abdominal Radiology
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-024-04360-2
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