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Combined external urethral bulking and artificial urinary sphincter for urethral atrophy and stress urinary incontinence.
BJU Int. 2005 Apr; 95(6):824-6.BI

Abstract

OBJECTIVE

To describe a technique of externally bulking the urethra with a soft-tissue graft before placing another artificial urinary sphincter (AUS), as when placing another AUS for recurrent male stress urinary incontinence (SUI) other manoeuvres, e.g. placing a tandem cuff or transcorporal cuff, must be used to obtain urinary continence in an atrophic urethra, and each is associated with morbidity.

PATIENTS AND METHODS

From January 2003 to July 2004, five patients (mean age 74 years, range 62-84) treated by radical prostatectomy were referred for recurrent SUI after placing an AUS (four, including one with urethral erosion) or a male sling (one, with a resulting atrophic urethra). Each patient was treated with an external urethral bulking agent (Surgisis) ES, Cook Urological, Spencer, Indiana) and had an AUS placed.

RESULTS

In each patient the greatest urethral circumference was <4 cm. To place a functional 4 cm cuff, the diameter of the urethra was enhanced by wrapping it with Surgisis ES. Continence was significantly improved in all patients except one 84-year-old man who had the replanted artificial sphincter removed because of erosion 14 months after surgery.

CONCLUSION

In cases of severe recurrent SUI from urethral atrophy after placing an AUS, externally bulking the urethra with Surgisis ES before placing another AUS is well tolerated, and gives satisfactory results.

Authors+Show Affiliations

Department of Urology, University of California, San Francisco, CA 94143, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15794791

Citation

Rahman, Nadeem U., et al. "Combined External Urethral Bulking and Artificial Urinary Sphincter for Urethral Atrophy and Stress Urinary Incontinence." BJU International, vol. 95, no. 6, 2005, pp. 824-6.
Rahman NU, Minor TX, Deng D, et al. Combined external urethral bulking and artificial urinary sphincter for urethral atrophy and stress urinary incontinence. BJU Int. 2005;95(6):824-6.
Rahman, N. U., Minor, T. X., Deng, D., & Lue, T. F. (2005). Combined external urethral bulking and artificial urinary sphincter for urethral atrophy and stress urinary incontinence. BJU International, 95(6), 824-6.
Rahman NU, et al. Combined External Urethral Bulking and Artificial Urinary Sphincter for Urethral Atrophy and Stress Urinary Incontinence. BJU Int. 2005;95(6):824-6. PubMed PMID: 15794791.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Combined external urethral bulking and artificial urinary sphincter for urethral atrophy and stress urinary incontinence. AU - Rahman,Nadeem U, AU - Minor,Thomas X, AU - Deng,Donna, AU - Lue,Tom F, PY - 2005/3/30/pubmed PY - 2005/5/17/medline PY - 2005/3/30/entrez SP - 824 EP - 6 JF - BJU international JO - BJU Int VL - 95 IS - 6 N2 - OBJECTIVE: To describe a technique of externally bulking the urethra with a soft-tissue graft before placing another artificial urinary sphincter (AUS), as when placing another AUS for recurrent male stress urinary incontinence (SUI) other manoeuvres, e.g. placing a tandem cuff or transcorporal cuff, must be used to obtain urinary continence in an atrophic urethra, and each is associated with morbidity. PATIENTS AND METHODS: From January 2003 to July 2004, five patients (mean age 74 years, range 62-84) treated by radical prostatectomy were referred for recurrent SUI after placing an AUS (four, including one with urethral erosion) or a male sling (one, with a resulting atrophic urethra). Each patient was treated with an external urethral bulking agent (Surgisis) ES, Cook Urological, Spencer, Indiana) and had an AUS placed. RESULTS: In each patient the greatest urethral circumference was <4 cm. To place a functional 4 cm cuff, the diameter of the urethra was enhanced by wrapping it with Surgisis ES. Continence was significantly improved in all patients except one 84-year-old man who had the replanted artificial sphincter removed because of erosion 14 months after surgery. CONCLUSION: In cases of severe recurrent SUI from urethral atrophy after placing an AUS, externally bulking the urethra with Surgisis ES before placing another AUS is well tolerated, and gives satisfactory results. SN - 1464-4096 UR - https://www.unboundmedicine.com/medline/citation/15794791/Combined_external_urethral_bulking_and_artificial_urinary_sphincter_for_urethral_atrophy_and_stress_urinary_incontinence_ L2 - https://doi.org/10.1111/j.1464-410X.2005.05409.x DB - PRIME DP - Unbound Medicine ER -