Mp76-11 No Clear Indication for Penile Implant Removal at the Time of Artificial Urinary Sphincter Explantation for Cuff Erosion

You have accessJournal of UrologySexual Function/Dysfunction: Surgical Therapy II (MP76)1 May 2024MP76-11 NO CLEAR INDICATION FOR PENILE IMPLANT REMOVAL AT THE TIME OF ARTIFICIAL URINARY SPHINCTER EXPLANTATION FOR CUFF EROSION Tyler M. Gaines, Jeffrey C. Loh-Doyle, Marisa Maas, Emily Markarian, Joaquin Michel, Nicole Matluck, Billy Cordon, Roger Klein, John Myrga, Paul Rusilko, Austin Livingston, Logan Grimaud, Jordan Foreman, Aaron Lentz, Andrew Peterson, Mark Mikhail, Alex Hwang, Anand Shridharani, Liliya Tryfonyuk, Francisco Martins, Rebecca Gonzalez, Grant Van Der Voort, Rohan Bhalla, Brian Flynn, Dmitriy Nikolavsky, and Jay Simhan Tyler M. GainesTyler M. Gaines , Jeffrey C. Loh-DoyleJeffrey C. Loh-Doyle , Marisa MaasMarisa Maas , Emily MarkarianEmily Markarian , Joaquin MichelJoaquin Michel , Nicole MatluckNicole Matluck , Billy CordonBilly Cordon , Roger KleinRoger Klein , John MyrgaJohn Myrga , Paul RusilkoPaul Rusilko , Austin LivingstonAustin Livingston , Logan GrimaudLogan Grimaud , Jordan ForemanJordan Foreman , Aaron LentzAaron Lentz , Andrew PetersonAndrew Peterson , Mark MikhailMark Mikhail , Alex HwangAlex Hwang , Anand ShridharaniAnand Shridharani , Liliya TryfonyukLiliya Tryfonyuk , Francisco MartinsFrancisco Martins , Rebecca GonzalezRebecca Gonzalez , Grant Van Der VoortGrant Van Der Voort , Rohan BhallaRohan Bhalla , Brian FlynnBrian Flynn , Dmitriy NikolavskyDmitriy Nikolavsky , and Jay SimhanJay Simhan View All Author Informationhttps://doi.org/10.1097/01.JU.0001009484.98400.42.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: It has been suggested with contemporary investigations that combined implantation of the artificial urinary sphincter (AUS) and inflatable penile prosthesis (IPP) performed either through staged or concomitant maneuvers could risk the long-term future of the AUS device. In the setting of AUS cuff erosion, the need for concomitant surgical removal of the IPP device remains unknown. We report AUS cuff survival outcomes in patients with dual AUS and IPP devices and further hypothesize acceptable IPP survivability in patients undergoing sole AUS removal at the time of cuff erosion. METHODS: Patients with a history of AUS and IPP device implantation were retrospectively reviewed from a multi-center database of experienced prosthetic urologists. Clinical characteristics, operative details, and surgical outcomes of patients who underwent staged or synchronous AUS/IPP device placement were compared. In those with AUS cuff erosion, the decision to remove the IPP at the time of AUS explant was left to the discretion of the surgeon. IPP device survival was characterized in patients who underwent AUS explanation secondary to a urethral cuff erosion event. RESULTS: 111 patients with combination AUS/IPP met inclusion criteria, including 82 patients who underwent staged placement of AUS/IPP prostheses and 29 patients with synchronous placement. The majority of patients in both cohorts had a history of pelvic radiotherapy (71% v. 66%, p=0.438). The overall rate of AUS erosion in patients with dual devices was 15% with no difference in rate of cuff erosion based on whether devices were implanted in a staged fashion or not (15.8% v. 13.7% p=0.11). A large fraction of dual implant patients underwent sole AUS device removal following cuff erosion (n=13, 76%). There was no difference in the AUS reimplantation rate between patients who underwent dual device removal (50%) and AUS only removal (57%) following cuff erosion (p=0.762) with overall second AUS survival of 75% at 12 months. Of 13 patients with IPP left in situ following AUS explantation, only 2 (15%) patients underwent subsequent IPP explantation within 12 months of AUS removal – both of whom had history of low testosterone and pelvic radiation. CONCLUSIONS: Our findings suggest feasible survival of the remaining IPP in patients who undergo sole AUS removal for urethral cuff erosion. Further, the presence of an IPP in a patient with prior AUS cuff erosion does not preclude future AUS placement. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1247 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Tyler M. Gaines More articles by this author Jeffrey C. Loh-Doyle More articles by this author Marisa Maas More articles by this author Emily Markarian More articles by this author Joaquin Michel More articles by this author Nicole Matluck More articles by this author Billy Cordon More articles by this author Roger Klein More articles by this author John Myrga More articles by this author Paul Rusilko More articles by this author Austin Livingston More articles by this author Logan Grimaud More articles by this author Jordan Foreman More articles by this author Aaron Lentz More articles by this author Andrew Peterson More articles by this author Mark Mikhail More articles by this author Alex Hwang More articles by this author Anand Shridharani More articles by this author Liliya Tryfonyuk More articles by this author Francisco Martins More articles by this author Rebecca Gonzalez More articles by this author Grant Van Der Voort More articles by this author Rohan Bhalla More articles by this author Brian Flynn More articles by this author Dmitriy Nikolavsky More articles by this author Jay Simhan More articles by this author Expand All Advertisement PDF downloadLoading ...