Int Neurourol J.
2019 Sep;23(3):219-225. 10.5213/inj.1938032.016.
Artificial Urinary Sphincter Cuff Size Predicts Outcome in Male Patients Treated for Stress Incontinence: Results of a Large Central European Multicenter Cohort Study
- Queissert
- Huesch T
- Kretschmer A
- Anding R
- Kurosch M
- Kirschner-Hermanns R
- Pottek T
- Olianas R
- Friedl A
- Pfitzenmaier J
- Naumann CM
- Wotzka C
- Nyarangi-Dix J
- Hoffmann T
- Herrmann E
- Obaje A
- Rose A
- Homberg R
- Abdunnur R
- Loertzer H
- Bauer RM
- Haferkamp
- Schrader A
- Debates on Male Incontinence (DOMINO)-Project
- Affiliations
-
- 1Department of Urology and Pediatric Urology, University Hospital of Muenster, Muenster, Germany. fabiqu@gmx.de
- 2Department of Urology and Pediatric Urology, University Medical Center of Johannes Gutenberg University, Mainz, Germany.
- 3Department of Urology, Ludwig-Maximilians University Hospital, Großhadern Campus, Munich, Germany.
- 4Department of Urology, Pediatric Urology, and Neurourology, University Hospital of Bonn, Bonn, Germany.
- 5Department of Urology, Vivantes Hospital Am Urban, Berlin, Germany.
- 6Department of Urology, Lueneburg Hospital, Lueneburg, Germany.
- 7Department of Urology, Goettlicher Heiland Hospital of Vienna, Vienna, Austria.
- 8Department of Urology, Bethel Evangelical Hospital, Bielefeld, Germany.
- 9Department of Urology and Pediatric Urology, University Hospital of Kiel, Kiel, Germany.
- 10Department of Urology, Diaconal Hospital of Stuttgart, Stuttgart, Germany.
- 11Department of Urology and Pediatric Urology, University Hospital of Heidelberg, Heidelberg, Germany.
- 12Department of Urology, Diaconal Hospital of Schwaebisch Hall, Schwaebisch Hall, Germany.
- 13Department of Urology and Robotic Surgery, Prosper-Hospital, Recklinghausen, Germany.
- 14Department of Urology, St. Bernward Hospital Hildesheim, Hildesheim, Germany.
- 15Department of Urology and Pediatric Urology, Helios Hospital Duisburg, Duisburg, Germany.
- 16Department of Urology and Pediatric Urology, St. Barbara Hospital Hamm GmbH, Hamm, Germany.
- 17Department of Urology and Pediatric Urology, Helios Hospital Schwelm, Schwelm, Germany.
- 18Department of Urology and Pediatric Urology, Westpfalz Medical Center, Kaiserslautern, Germany.
- KMID: 2460734
- DOI: http://doi.org/10.5213/inj.1938032.016
Abstract
- PURPOSE
The aim was to study the correlation between cuff size and outcome after implantation of an AMS 800 artificial urinary sphincter.
METHODS
A total of 473 male patients with an AMS 800 sphincter implanted between 2012 and 2014 were analyzed in a retrospective multicenter cohort study performed as part of the Central European Debates on Male Incontinence (DOMINO) Project.
RESULTS
Single cuffs were implanted in 54.5% and double cuffs in 45.5% of the patients. The cuffs used had a median circumference of 4.5 cm. Within a median follow of 18 months, urethral erosion occurred in 12.8% of the cases and was associated significantly more often with small cuff sizes (P<0.001). Multivariate analysis showed that, apart from cuff size (P=0.03), prior irradiation (P<0.001) and the penoscrotal approach (P=0.036) were associated with an increased erosion rate. Continence rate tended to be highest with median cuff sizes (4-5.5 cm).
CONCLUSIONS
Apart from irradiation and the penoscrotal approach, small cuff size is a risk factor for urethral erosion. Results are best with cuff sizes of 4.5-5.5 cm.
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