Artificial Urinary Sphincter Cuff Size Predicts Outcome in Male Patients Treated for Stress Incontinence: Results of a Large Central European Multicenter Cohort Study

• Published in: International Neurourology Journal
• Main Authors: Fabian Queissert, Tanja Huesch, Alexander Kretschmer, Ralf Anding, Martin Kurosch, Ruth Kirschner-Hermanns, Tobias Pottek, Roberto Olianas, Alexander Friedl, Jesco Pfitzenmaier, Carsten M. Naumann, Carola Wotzka, Joanne Nyarangi-Dix, Torben Hoffmann, Edwin Herrmann, Alice Obaje, Achim Rose, Roland Homberg, Rudi Abdunnur, Hagen Loertzer, Ricarda M. Bauer, Axel Haferkamp, Andres J. Schrader
• Format: Article
• Language: English
• Published: Korean Continence Society 2019-09-01
• Subjects: artificial urinary sphincter; ams 800; cuff size; male; stress urinary incontinence; single or double cuff
• Online Access: http://www.einj.org/upload/pdf/inj-1938032-016.pdf
• ISSN: 2093-4777; 2093-6931

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.