Mp03-10 Natural History of Artificial Urinary Sphincter Erosion: Long-Term Lower Urinary Tract Outcomes and Incontinence Management

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Male Incontinence (MP03)1 May 2024MP03-10 NATURAL HISTORY OF ARTIFICIAL URINARY SPHINCTER EROSION: LONG-TERM LOWER URINARY TRACT OUTCOMES AND INCONTINENCE MANAGEMENT Bridget L. Findlay, Sierra T. Pence, Cameron J. Britton, Anthony Fadel, Brian J. Linder, and Daniel S. Elliott Bridget L. FindlayBridget L. Findlay , Sierra T. PenceSierra T. Pence , Cameron J. BrittonCameron J. Britton , Anthony FadelAnthony Fadel , Brian J. LinderBrian J. Linder , and Daniel S. ElliottDaniel S. Elliott View All Author Informationhttps://doi.org/10.1097/01.JU.0001009488.55564.85.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Urethral erosion is a serious complication of artificial urinary sphincter (AUS) surgery, with significant quality of life implications. We aim to describe long-term lower urinary tract outcomes and incontinence management after AUS erosion, including risk factors associated with each outcome. METHODS: We queried our prospectively maintained AUS database from 1/1/1986-10/31/2023 for men undergoing device explantation for urethral erosion. Baseline characteristics, including age, history of prostatectomy, radiation, hormone therapy (ADT), as well as presence of urethral stricture prior to primary AUS implantation were collected. Outcomes included time to erosion, development of urethral stricture, and management of post explant incontinence (pads/clamp, catheter, salvage AUS, ileal/colon conduit urinary diversion). Risk factors were tested for association with stricture formation and repeat erosion using logistic regression. RESULTS: 1943 unique patients underwent AUS implantation during the study period, and 217 (11%) had a device explantation for urethral erosion. Of these, 194 had complete records available and were included in the analysis. Baseline characteristics are shown in Table 1. Median follow-up was 7.5 (IQR 2.7-13.7) yrs. Median age at first implant was 71 (IQR 66-76) yrs, and median time to erosion was 2 yrs (IQR 0-6). Of the cases included, 94 patients went on to salvage AUS placement. Of those, 38 (40%) were explanted for subsequent erosion, and 16/38 (42%) had a 2nd salvage AUS after that. On multivariable analysis, no factors were significantly associated with the risk of salvage AUS erosion. Radiation (OR 2.9; CI 1.1-7.3; p=0.03) and urethral reconstruction at the time of erosion (OR 3.2; CI 1.2-8.7; p=0.02) were both associated with increased risk of urethral stricture on multivariable model, whereas older age at first implant was protective (OR 0.94; CI 0.90-0.99; p=0.04. CONCLUSIONS: Following AUS erosion, radiation history and urethral reconstruction at the time of device explant were risk factors for development of urethral stricture. Salvage AUS placement after erosion was feasible, though with a relatively high rate of repeat urethral erosion. Source of Funding: N/A © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e26 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Bridget L. Findlay More articles by this author Sierra T. Pence More articles by this author Cameron J. Britton More articles by this author Anthony Fadel More articles by this author Brian J. Linder More articles by this author Daniel S. Elliott More articles by this author Expand All Advertisement PDF downloadLoading ...