1.Artificial Urinary Sphincter Cuff Size Predicts Outcome in Male Patients Treated for Stress Incontinence: Results of a Large Central European Multicenter Cohort Study
Fabian QUEISSERT ; Tanja HUESCH ; Alexander KRETSCHMER ; Ralf ANDING ; Martin KUROSCH ; Ruth KIRSCHNER-HERMANNS ; Tobias POTTEK ; Roberto OLIANAS ; Alexander FRIEDL ; Jesco PFITZENMAIER ; Carsten M NAUMANN ; Carola WOTZKA ; Joanne NYARANGI-DIX ; Torben HOFFMANN ; Edwin HERRMANN ; Alice OBAJE ; Achim ROSE ; Roland HOMBERG ; Rudi ABDUNNUR ; Hagen LOERTZER ; Ricarda M BAUER ; Axel HAFERKAMP ; Andres J SCHRADER ;
International Neurourology Journal 2019;23(3):219-225
PURPOSE: The aim was to study the correlation between cuff size and outcome after implantation of an AMS 800 artificial urinary sphincter. METHODS: A total of 473 male patients with an AMS 800 sphincter implanted between 2012 and 2014 were analyzed in a retrospective multicenter cohort study performed as part of the Central European Debates on Male Incontinence (DOMINO) Project. RESULTS: Single cuffs were implanted in 54.5% and double cuffs in 45.5% of the patients. The cuffs used had a median circumference of 4.5 cm. Within a median follow of 18 months, urethral erosion occurred in 12.8% of the cases and was associated significantly more often with small cuff sizes (P<0.001). Multivariate analysis showed that, apart from cuff size (P=0.03), prior irradiation (P<0.001) and the penoscrotal approach (P=0.036) were associated with an increased erosion rate. Continence rate tended to be highest with median cuff sizes (4–5.5 cm). CONCLUSIONS: Apart from irradiation and the penoscrotal approach, small cuff size is a risk factor for urethral erosion. Results are best with cuff sizes of 4.5–5.5 cm.
Cohort Studies
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Humans
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Male
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Multivariate Analysis
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Retrospective Studies
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Risk Factors
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Urinary Sphincter, Artificial