Document Detail


Urethral Buttressing in Patients Undergoing Artificial Urinary Sphincter Surgery.
MedLine Citation:
PMID:  23206425     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: To evaluate the safety and feasibility of a novel technique of buttressing the urethra with a fibrin-coated collagen fleece in patients undergoing artificial urinary sphincter (AUS) surgery in the presence of urethral atrophy. MATERIALS AND METHODS: A total of 17 consecutive men underwent urethral buttressing for urethral atrophy during AUS surgery. Continence, complications, and patient-reported outcome were assessed by pre- and postoperative pad usage, chart review, patient interview, and validated questionnaires. RESULTS: The mean follow-up was 38±3.0 months (median 34, range 23-71). 1 patient was excluded from further evaluation because of accidental iatrogenic urethral injury at another hospital. At 3-month follow-up the mean improvement in pad use was 5±0.5 pads (median 5, range 2-9). A pad use of 1 and 0 per day, was reported by 56% (9/16) and 13% (2/16) of patients, respectively. 75% (12/16) described their condition as much or very much better after surgery according to the Patient Global Impression of Improvement questionnaire (PGI-I). The mean postoperative Incontinence Impact Questionnaire (IIQ-SF) and Urogenital Distress Index (UDI-SF) scores were 2±0.8 (median 1, range 0-11) and 4±1.0 (median 3, range 0-11), respectively. No intraoperative complications were observed. During follow-up 13% (2/16) of patients underwent placement of a second cuff because of unsatisfactory postoperative continence. 6% (1/16) underwent AUS revision for clean urethral erosion, and 6% (1/16) underwent revision for pump malfunction. CONCLUSION: Urethral buttressing with a collagen fleece appears to be a safe and feasible option for urethral atrophy in patients undergoing AUS implantation or revision.
Authors:
Markus Margreiter; Alex Farr; Varun Sharma; Ingrid Schauer; Hans-Christoph Klingler
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-30
Journal Detail:
Title:  The Journal of urology     Volume:  -     ISSN:  1527-3792     ISO Abbreviation:  J. Urol.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-12-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376374     Medline TA:  J Urol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Urology, Medical University of Vienna, Vienna, Austria. Electronic address: markus.margreiter@meduniwien.ac.at.
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