New Surgical Technique for Sphincter Urinary Control System Using Upper Transverse Scrotal Incision

No AccessJournal of UrologyCLINICAL UROLOGY: Urologists at Work1 Jan 2003New Surgical Technique for Sphincter Urinary Control System Using Upper Transverse Scrotal Incision STEVEN K. WILSON, JOHN R. DELK, GERARD D. HENRY, and ANDREW L. SIEGEL STEVEN K. WILSONSTEVEN K. WILSON , JOHN R. DELKJOHN R. DELK , GERARD D. HENRYGERARD D. HENRY , and ANDREW L. SIEGELANDREW L. SIEGEL View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)64082-7AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Traditional implantation of the AMS Sphincter 800 Urinary Control System (American Medical Systems, Minnetonka, Minnesota) requires 2 incisions. The cuff is placed via a perineal incision, and the pressure regulating balloon and pump are placed through a separate suprapubic incision. We describe a novel implantation of all the artificial urinary sphincter components using a single upper scrotal incision. The scrotal incision allows excellent access to the proximal bulbar urethra and retropubic and subdartos spaces, and leaves the bulbocavernosus muscle intact. Materials and Methods: A total of 37 patients have undergone artificial urinary sphincter implantation using the new operative technique for revisions or reimplantations of a sphincter previously removed for infection/erosion (12) or as an initial procedure (25). In 9 of the 25 patients and 2 of the 12 dual implantation of a 3-piece penile prosthesis through the same incision was performed. Results: All patients are using the devices. Of the patients 66% are completely dry with no pad use and the remainder use 1 pad for accident prevention. Operative time was reduced due to easier exposure of the urethra and a second incision for placement of the pressure regulating balloon was not necessary. Followup at 1 year shows no difference in complication rate with the single incision technique compared to the traditional method. Conclusions: Artificial urinary sphincter implantation through a single scrotal incision is easier and faster than the traditional 2-incision technique. Success in achieving continence is similar to traditional methods. Long-term followup is necessary to ensure that complications remain low. References 1 : A new approach for implantation of artificial urinary sphincter: upper transverse scrotal incision. J Urol2001; 165: 256. abstract 1053. Google Scholar 2 : Postprostatectomy urinary incontinenaaa the case for artificial urinary sphincter implantation. Urology2000; 55: 2. Google Scholar 3 : Artificial urinary sphincter for post-radical prostatectomy urinary incontinenaaa long-term subjective results. J Urol2001; 166: 1755. Abstract, Google Scholar 4 : Experience with the artificial urinary sphincter model AS800 in 148 patients. J Urol1989; 141: 307. Link, Google Scholar 5 : Use of a double cuff AMS800 urinary sphincter for severe stress incontinence. J Urol1993; 149: 283. 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Google Scholar From the Institute for Urologic Excellence, Van Buren, Arkansas, and the Department of Urology, Hackensack University Medical Center, Hackensack, New Jersey© 2003 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byYafi F, DeLay K, Stewart C, Chiang J, Sangkum P and Hellstrom W (2016) Device Survival after Primary Implantation of an Artificial Urinary Sphincter for Male Stress Urinary IncontinenceJournal of Urology, VOL. 197, NO. 3 Part 1, (759-765), Online publication date: 1-Mar-2017.Segal R, Cabrini M, Harris E, Mostwin J, Bivalacqua T and Burnett A (2018) Combined Inflatable Penile Prosthesis-Artificial Urinary Sphincter Implantation: No Increased Risk of Adverse Events Compared to Single or Staged Device ImplantationJournal of Urology, VOL. 190, NO. 6, (2183-2188), Online publication date: 1-Dec-2013.Anusionwu I, Miles-Thomas J, Hernandez D and Wright E (2018) Anatomical and Manometric Comparison of Perineal and Transscrotal Approaches to Artificial Urinary Sphincter PlacementJournal of Urology, VOL. 188, NO. 5, (1834-1836), Online publication date: 1-Nov-2012.Schlomer B, Dugi D, Valadez C and Morey A (2018) Correlation of Penile and Bulbospongiosus Measurements: Implications for Artificial Urinary Sphincter Cuff PlacementJournal of Urology, VOL. 183, NO. 4, (1474-1478), Online publication date: 1-Apr-2010.Siegel A (2018) Re: Perineal Approach for Artificial Urinary Sphincter Implantation Appears to Control Male Stress Incontinence Better Than the Transscrotal ApproachJournal of Urology, VOL. 181, NO. 1, (417-418), Online publication date: 1-Jan-2009.Henry G, Graham S, Cornell R, Cleves M, Simmons C, Vakalopoulos I and Flynn B (2018) A Multicenter Study on the Perineal Versus Penoscrotal Approach for Implantation of an Artificial Urinary Sphincter: Cuff Size and Control of Male Stress Urinary IncontinenceJournal of Urology, VOL. 182, NO. 5, (2404-2409), Online publication date: 1-Nov-2009.Henry G, Graham S, Cleves M, Simmons C and Flynn B (2018) Perineal Approach for Artificial Urinary Sphincter Implantation Appears to Control Male Stress Incontinence Better Than the Transscrotal ApproachJournal of Urology, VOL. 179, NO. 4, (1475-1479), Online publication date: 1-Apr-2008. Volume 169Issue 1January 2003Page: 261-264 Advertisement Copyright & Permissions© 2003 by American Urological Association, Inc.Keywordsurinary sphincterartificialurinary incontinenceurethraMetricsAuthor Information STEVEN K. WILSON Requests for reprints: 2010 Chestnut St., Van Buren, Arkansas, 72956. Financial interest and/or other relationship with American Medical Systems and Mentor. More articles by this author JOHN R. DELK Financial interest and/or other relationship with American Medical Systems. More articles by this author GERARD D. HENRY Financial interest and/or other relationship with American Medical Systems and Mentor. More articles by this author ANDREW L. SIEGEL More articles by this author Expand All Advertisement PDF downloadLoading ...