Most men with artificial urinary sphincter cuff erosion have low serum testosterone levels.

Autor: Wolfe AR; Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA., Ortiz NM; Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA., Baumgarten AS; Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA., VanDyke ME; Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA., West ML; Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA., Dropkin BM; Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA., Joice GA; Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA., Sanders SC; Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA., Hudak SJ; Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA., Morey AF; Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Jazyk: angličtina
Zdroj: Neurourology and urodynamics [Neurourol Urodyn] 2021 Apr; Vol. 40 (4), pp. 1035-1041. Date of Electronic Publication: 2021 Apr 01.
DOI: 10.1002/nau.24663
Abstrakt: Aims: To evaluate the relationship between serum testosterone (T) levels and artificial urinary sphincter (AUS) cuff erosion in a population of incontinent men who underwent AUS placement.
Methods: A retrospective analysis of our single-surgeon AUS database was performed to identify men with T levels within 24 months of AUS placement. Men were stratified into two groups based on serum testosterone: low serum testosterone (LT) (<280 ng/dl) and normal serum testosterone (NT) (>280 ng/dl). Multivariable analysis was performed to control for risk factors. The outcome of interest was the incidence of and time to spontaneous urethral cuff erosion; other risk factors for cuff erosion were also evaluated.
Results: Among 161 AUS patients with serum testosterone levels, 84 (52.2%) had LT (mean: 136.8 ng/dl, SD: 150.4 ng/dl) and 77 (47.8%) had NT (mean: 455.8 ng/dl, SD: 197.3 ng/dl). Cuff erosion was identified in 42 men (26.1%) at a median of 7.1 months postoperatively (interquartile range: 3.6-13.4 months), most of whom (30/42, 71.4%) were testosterone deficient. LT levels were less common (54/119, 45.4%) in the non-erosion cohort (p = 0.004). Men with low T were nearly three times as likely to suffer AUS erosion than men with normal T (odds ratio = 2.519, p = 0.021). LT level was the only factor associated with AUS erosion on multivariable analysis.
Conclusions: LT is an independent risk factor for AUS cuff erosion. Men with LT are more likely to present with cuff erosion, but there is no difference in time to erosion.
(© 2021 Wiley Periodicals LLC.)
Databáze: MEDLINE
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