Urethral atrophy after artificial urinary sphincter placement: Is cuff downsizing effective?

Amir Saffarian, Kilian Walsh, Ian K. Walsh, Anthony R Stone

Research output: Contribution to journalArticle

43 Scopus citations

Abstract

Purpose: We reviewed the outcome of cuff downsizing with an artificial urinary sphincter for treating recurrent incontinence due to urethral atrophy. Materials and Methods: We analyzed the records of 17 patients in a 7-year period in whom clinical, radiological and urodynamic evidence of urethral atrophy was treated with cuff downsizing. Cuff downsizing was accomplished by removing the existing cuff and replacing it with a 4 cm. cuff within the established false capsule. Incontinence and satisfaction parameters before and after the procedure were assessed by a validated questionnaire. Results: Mean patient age was 70 years (range 62 to 79). Average time to urethral atrophy was 31 months (range 5 to 96) after primary sphincter implantation. Mean followup after downsizing was 22 months (range 1 to 64). Cuff downsizing caused a mean decrease of 3.9 to 0.5 pads daily. The number of severe leakage episodes decreased from a mean of 5.4 to 2.1 The mean SEAPI (stress leakage, emptying, anatomy, protection, inhibition) score decreased from 8.2 to 2.4. Patient satisfaction increased from 15% to 80% after cuff downsizing. In 1 patient an infected cuff required complete removal of the device. Conclusions: Patient satisfaction and continence parameters improved after cuff downsizing. We believe that this technique is a simple and effective method of restoring continence after urethral atrophy.

Original languageEnglish (US)
Pages (from-to)567-569
Number of pages3
JournalJournal of Urology
Volume169
Issue number2
DOIs
StatePublished - Feb 1 2003

Keywords

  • Atrophy
  • Questionnaires
  • Urethra
  • Urinary sphincter, artificial

ASJC Scopus subject areas

  • Urology

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