Clinical case of artificial urinary sphincter function restoration in a patient with urethral destruction at the cuff site
https://doi.org/10.17650/1726-9776-2025-21-1-112-118
Abstract
Implantation of an artificial urinary sphincter is the most studied and most effective method of surgical treatment of severe stress urinary incontinence in men. If urethral erosion develops at the cuff site, it is only possible to restore the device’s function and regain the previous level of quality of life through a multi-stage procedure.
This paper describes a clinical case of multistage treatment of a patient with urethral erosion at the site of the artificial urinary sphincter cuff and provides a review of the literature.
About the Authors
A. A. TomilovRussian Federation
Andrey Aleksandrovich Tomilov
5 2nd Botkinskiy Proezd, Moscow 125284; Build. 1, 2/1 Barrikadnaya St., Moscow 125993
Competing Interests:
The authors declare no conflict of interest
E. I. Veliev
Russian Federation
5 2nd Botkinskiy Proezd, Moscow 125284; Build. 1, 2/1 Barrikadnaya St., Moscow 125993
Competing Interests:
The authors declare no conflict of interest
E. N. Golubtsova
Russian Federation
5 2nd Botkinskiy Proezd, Moscow 125284; Build. 1, 2/1 Barrikadnaya St., Moscow 125993
Competing Interests:
The authors declare no conflict of interest
References
1. EAU Guidelines. Edn. presented at the EAU Annual Congress Milan March 2023.
2. Veliev E.I., Tomilov A.A. Current possibilities of urinary incontinence diagnosis and treatment in men. Moscow: Vidal Rus, 2020. 80 p. (In Russ.).
3. Kotov S.V., Pavlov I.S. Correction of urinary incontinence after radical prostatectomy. Surgical technique step by step. Eksperimental’naya i klinicheskaya urologiya = Experimental and Clinical Urology 2020;13(5):22–9. (In Russ.). DOI: 10.29188/2222854320201352229
4. Kyzlasov P.S., Filimonov V.B., Vasin R.V. et al. Simultaneous surgical correction of stress urinary intention and erectile dysfunction after surgical treatment of prostate cancer. Eksperimental’naya i klinicheskaya urologiya = Experimental and Clinical Urology 2023;16(1):55–9. (In Russ.). DOI: 10.29188/2222854320231615559
5. Ramazanov K.K., Akhvlediani N.D., Savchenko A.V., Pushkar D.Yu. Implantation of an artificial urinary sphincter for urinary incontinence after radical prostatectomy (current aspects). Andrologiya i genital’naya khirurgiya = Andrology and Genital Surgery 2022;23(1):21–9. (In Russ.). DOI: 10.17650/1726978420222312129
6. Tomilov A.A., Veliev E.I., Golubtsova E.N. et al. Artificial urinary sphincter implantation: outcomes evaluation in a cohort of patients beyond a tenyear followup. Vestnik urologii = Urology Herald 2024;12(1):91–7. (In Russ.). DOI: 10.21886/2308642420241219197
7. CorralesAcosta E., Corrales M., ArenasAquino A.E., Melgarejo García G. Artificial urinary sphincter outcomes for postradical prostatectomy urinary incontinence. A narrative review. Rev Mex Urol 2022;81(6):1–13. DOI: 10.48193/revistamexicanadeurologa.v81i6.826
8. Desai T.J., Rozanski AT. Artificial urinary sphincter erosion and infection: a contemporary review of perioperative considerations and management. Transl Androl Urol 2024;13(5):857–67. DOI: 10.21037/tau23488
9. Sandhu J.S., Breyer B., Comiter C. et al. Incontinence after prostate treatment: AUA/SUFU guideline. J Urol 2019;202(2):369–78. DOI: 10.1097/JU.0000000000000314
10. Schillebeeckx C., Deruyver Y., Beels E. et al. Longterm functional outcomes and patient satisfaction of artificial urinary sphincter implantation for male nonneurogenic incontinence: a retrospective study of 30year experience in a tertiary centre. Paper presented at: 2021 International Continence Society Annual Meeting; October 14–17, 2021; virtual. Accessed October 20, 2021. Available at: https://www.ics.org/2021/abstract/4
11. Veliev E.I., Tomilov A.A., Golubtsova E.N. Longterm efficacy and safety of artificial urinary sphincter AMS 800тм implantations. Vestnik urologii = Urology Herald 2021;9(1):14–21. (In Russ.). DOI: 10.21886/230864242021911421
12. Diao L., Nealon S.W., Carpinito G.P. et al. Presenting signs and symptoms of artificial urinary sphincter cuff erosion. Int Braz J Urol 2022;48(4):679–85. DOI: 10.1590/S16775538.IBJU.2022.0089
13. Redmond E., Tong S., Zemp L. et al. Improved artificial urinary sphincter outcomes using a transcorporal cuff placement in patients with a “fragile urethra”. Can Urol Assoc J 2020 14(12):E621–4. DOI: 10.5489/cuaj.6431
14. Mann R.A., Kasabwala K., Buckley J.C. et al. The “fragile” urethra as a predictor of early artificial urinary sphincter erosion. Urology 2022;169:233–6. DOI: 10.1016/j.urology.2022.06.023
15. Hoy N.Y., Rourke K.F. Artificial urinary sphincter outcomes in the “fragile urethra”. Urology 2015;86(3):618–24. DOI: 10.1016/j.urology.2015.05.023
16. Tomilov A.A., Veliev E.I., Golubtsova E.N. Clinical case of primary transcorporal artificial urinary sphincter cuff implantation. Onkourologiya = Cancer Urology 2024;20(1):134–9. (In Russ.). DOI: 10.17650/172697762024201134139
17. Kuhlencord K., Dahlem R., Vetterlein M.W. et al. Urethral stricture formation following cuff erosion of AMS artificial urinary sphincter devices: implication for a less invasive explantation approach. Front Surg 2022;9:829517. DOI: 10.3389/fsurg.2022.829517
18. Siegel J.A., Tausch T.J., Morey A.F. In situ urethroplasty after artificial urinary sphincter cuff erosion. Transl Androl Urol 2015;4(1):56–9. DOI: 10.3978/j.issn.22234683.2015.01.12
19. Rozanski A.T., Tausch T.J., Ramirez D. et al. Immediate urethral repair during explantation prevents stricture formation after artificial urinary sphincter cuff erosion. J Urol 2014;192(2):442–6. DOI: 10.1016/j.juro.2014.02.007
20. Gross M.S., Broghammer J.A., Kaufman M.R. et al. Urethral stricture outcomes after artificial urinary sphincter cuff erosion: results from a multicenter retrospective analysis. Urology 2017;104:198–203. DOI: 10.1016/j.urology.2017.01.020
21. Rozanski A.T., Viers B.R., Shakir N.A. et al. Is Removal of the pressureregulating balloon necessary after artificial urinary sphincter cuff erosion? Urology 2018;113:225–9. DOI: 10.1016/j.urology.2017.11.003
22. Cavalcanti A.G. Impact of artificial urinary sphincter erosion in the reimplantation of the device. Int Braz J Urol 2022;48(4):686–7. DOI: 10.1590/S16775538.IBJU.2022.0089.1
23. Cefalu C.A., Deng X., Zhao L.C. et al. Safety of the “drain and retain” option for defunctionalized urologic prosthetic balloons and reservoirs during artificial urinary sphincter and inflatable penile prosthesis revision surgery: 5year experience. Urology 2013;82(6):1436–9. DOI: 10.1016/j.urology.2013.07.038
24. Dobberfuhl A.D., Comiter C.V. A systematic approach to the evaluation and management of the failed artificial urinary sphincter. Curr Urol Rep 2017;18(3):18. DOI: 10.1007/s119340170666y
25. Van der Aa F., Drake M.J., Kasyan G.R. et al.; Young Academic Urologists Functional Urology Group. The artificial urinary sphincter after a quarter of a century: a critical systematic review of its use in male nonneurogenic incontinence. Eur Urol 2013;63(4):681–9. DOI: 10.1016/j.eururo.2012.11.034
26. Motley R.C., Barrett D.M. Artificial urinary sphincter cuff erosion. Experience with reimplantation in 38 patients. Urology 1990;35(3):215–8. DOI: 10.1016/00904295(90)80034k
27. Bell B.B., Mulcahy J.J. Management of cuff erosion of the double cuff artificial urinary sphincter. J Urol 2000;163(1):85–6.
28. Magera J.S. Jr, Elliott D.S. Artificial urinary sphincter infection: causative organisms in a contemporary series. J Urol 2008;180(6):2475–8. DOI: 10.1016/j.juro.2008.08.021
29. Kowalczyk J.J., Spicer D.L., Mulcahy J.J. Erosion rate of the double cuff AMS800 artificial urinary sphincter: longterm followup. J Urol 1996;156(4):1300–1.
Review
For citations:
Tomilov A.A., Veliev E.I., Golubtsova E.N. Clinical case of artificial urinary sphincter function restoration in a patient with urethral destruction at the cuff site. Cancer Urology. 2025;21(1):112-118. (In Russ.) https://doi.org/10.17650/1726-9776-2025-21-1-112-118