Urethral Stricture Outcomes After Artificial Urinary Sphincter Cuff Erosion: Results From a Multicenter Retrospective Analysis
| Autor: | Jeffrey D. Brady, Christopher McClung, Michael B. Pryor, Mario A. Cleves, Gerard D. Henry, LeRoy Jones, Martin S. Gross, Joshua A. Broghammer, Melissa R. Kaufman, Douglas F. Milam, Travis Dum, William O. Brant |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty DNA Repair Urethral stricture Urology Urethroplasty medicine.medical_treatment Population 030232 urology & nephrology Artificial urinary sphincter Young Adult 03 medical and health sciences Postoperative Complications 0302 clinical medicine Urethra Risk Factors Statistical significance medicine Retrospective analysis Humans Postoperative Period education Device Removal Aged Retrospective Studies Aged 80 and over Urethral Stricture education.field_of_study business.industry Medical record Middle Aged medicine.disease Prosthesis Failure Surgery 030220 oncology & carcinogenesis Cuff Urinary Sphincter Artificial Urologic Surgical Procedures business |
| Zdroj: | Urology. 104:198-203 |
| ISSN: | 0090-4295 |
| DOI: | 10.1016/j.urology.2017.01.020 |
| Popis: | Objective To evaluate the influence of both repair type and degree of cuff erosion on postoperative urethral stricture rate. Sparse literature exists regarding patient outcomes after artificial urinary sphincter (AUS) cuff erosion. Surgeons from 6 high-volume male continence centers compiled a comprehensive database of post-erosion patients to examine outcomes. Materials and Methods This retrospective multi-institution study included 80 patients treated for AUS cuff erosions. Seventy-eight patients had specific information regarding post-cuff erosion urethral strictures. Erosion patients were categorized into 1 of 3 repair types at the time of explant surgery: catheter only, single-layer capsule-to-capsule repair (urethrorrhaphy), and formal urethroplasty. Operative notes and available medical records were extensively reviewed to collect study data. Results Twenty-five of 78 patients manifested a urethral stricture after AUS cuff erosion (32%). More strictures occurred among patients who underwent urethrorrhaphy (40% vs 29% for catheter only and 14% for urethroplasty). Stricture rates did not vary significantly by repair type ( P = .2). Strictures occurred significantly more frequently in patients with complete cuff erosions (58%) as compared to partial erosions (25%, P = .037). A trend was detected regarding increased percentage of erosion correlating with increased stricture rate, but this did not reach statistical significance ( P = .057). Partially eroded patients were more likely to undergo urethrorrhaphy repair (60%, P = .002). Conclusion Urethral stricture was more likely to occur after complete cuff erosion as opposed to partial erosion in this multicenter retrospective population. Repair type, whether catheter only, urethrorrhaphy, or formal urethroplasty, did not appear to influence postoperative stricture rate. |
| Databáze: | OpenAIRE |
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