Presentation Authors: Abdulhadi Akhtar*, Michael Davenport, Nabeel Shakir, Yooni Yi, Rachel Bergeson, Allen Morey, Dallas, TX
Introduction: The transcorporal artificial urinary sphincter (TC AUS) has traditionally been utilized in high-risk patients with urethral atrophy or prior urethral erosion. The 3.5 cm AUS cuff has been developed for use in a similar population. We compared the outcomes of TC AUS and 3.5 cm cuff patients to assess whether the TC approach was protective against urethral complications.
Methods: We performed a retrospective review for all men who underwent TC AUS and 3.5 cm AUS implantation by a single surgeon from 2007 to 2018 at a tertiary medical center. Demographic and outcomes data were collected and analyzed after database review to evaluate for rates of urethral erosion. Multivariate logistic regression was performed to identify co-morbid factors associated with urethral erosion.
Results: In our database of 635 AUS patients, we identified 62 (9.8%) men with TC AUS and 127 (20%) having a 3.5 cm cuff. Over a median follow-up time of 49 months, 28 (45%) men with TC cuffs developed urethral erosion compared with 14 (11%) men with a 3.5 cm cuff. On univariate analysis, a TC cuff was associated with increased odds of erosion (OR 6.65, CI 3.20-14.4, p < 0.0001) when compared with a 3.5 cm cuff. On multivariate analysis, TC cuffs continued to portend significantly increased odds of cuff erosion.
Conclusions: TC AUS may not be protective against urethral complications of AUS when compared to 3.5 cm cuff patients.