MP40: Urodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Male Incontinence: Therapy I
MP40-16: Volume measurement on the AMS 800&[trade] peri-bulbar occlusive cuff after pressurization with the pressure-regulating balloon: a prospective single center study.
Friday, May 15, 2020
7:00 AM – 9:00 AM
Christine Reus, Véronique Phé, Emmanuel chartier-kastler, Aurélien Beaugerie, Pierre Mozer
Introduction: The manufacturer recommends filling the pressure-regulating balloon (PRB) with 22 cc of isotonic solution at the time of implantation, whilst the occlusive cuff (OC) is empty. In order to maintain the desired pressure range, OC pressurization is an optional step allowing subsequent OC filling with at least 2cc of solution remaining in the PRB. However, the exact volume required is unknown.
The aim of the study was to measure the volume on the AMS 800™peri-bulbar OC after pressurization with the PRB at the time of implantation. This would determine the exact PRB filling volume required to deliver the adequate pressure and understand the functioning of the system, such as it is known today.
Methods: A prospective, single center, intra-operative OC volume measurements of implanted AMS 800™after pressurization with the PRB was conducted between October 2016 and November 2018. Ethical approval and informed consent were obtained and the study followed institutional protocol. The procedure was performed using a 5 ml Luerlock seringe and the 15-gauge blunt needle provided in the implantation kit, connected to the OC tubing after pressurization.
Results: The study included a total of 67 peri-bulbar OC implanted in men, aged 40 - 88 years old, by 4 surgeons. All selected PRB pressures were 61-70 cm H2O. Implanted OC cuff sizes were given by the cuff sizer, as follows: 3.5 cm (n=1), 4cm (n=29), 4.5 cm (n=26), 5 cm (n=9), 5.5 cm (n=1) and 6 cm (n=1). The measured OC volumes ranged between 0.05 and 1cc, with a median volume of 0.30 cc (+/SD=0.19) and a mean volume of 0.34 cc (figure a.).
Conclusions: Our study showed that the larger the cuff, the more volume it would accommodate after pressurization in order to fit the urethra. However this volume did not exceed 1 cc. The following step will consider long-term erosion rates related to cuff volume and its consequent impact. Source of