PURPOSE: To compare functional outcomes of those receiving artificial urinary sphincter (AUS) pressure regulating balloons (PRB) within the space of Retzius (SOR) versus those placed in a high sub-muscular (HSM) location.
METHODS: We reviewed a prospectively maintained database of AUS patients between July 2007 and December 2014. After cuff placement was completed via a perineal incision, 61-70 cm H2O PRBs were placed through a separate high scrotal incision in either a HSM tunnel or within the SOR. Demographics, perioperative comorbidities, and functional outcomes were compared between groups.
RESULTS: A total of 294 consecutive patients underwent AUS placement with a mean follow up of 23 months. SOR placement was performed in 140 (48%) patients while HSM placement was performed in 154 (52%). Functional outcomes including continence (defined as 0-1 pads/day) (81% vs. 88%, p=0.11), erosion (9% vs. 8%, p=0.66), and explantation (10% vs. 11%, p=0.62) rates were similar between groups. AUS revisions for persistent incontinence were required in similar proportions for both groups (13% vs. 8%, p=0.16), with comparable mean follow-up (24 vs. 23 months, p=0.30). Kaplan-Meier analysis revealed no difference between groups with regards to rates of explantation (p=0.70) or revision (p=0.06).
CONCLUSIONS: High sub-muscular placement of the PRB at the time of AUS surgery is a safe and effective alternative with equivalent functional outcomes to traditional placement in the SOR.
Written by:
Singla N, Siegel JA, Simhan J, Tausch TJ, Klein A, Thoreson GR, Morey AF. Are you the author?
Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX 75390.
Reference: J Urol. 2015 Feb 21. pii: S0022-5347(15)00390-0.
doi: 10.1016/j.juro.2015.01.115
PubMed Abstract
PMID: 25711196