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Queissert, Fabian; Huesch, Tanja; Kretschmer, Alexander; Anding, Ralf; Kurosch, Martin; Kirschner-Hermanns, Ruth; Pottek, Tobias; Oliana, Roberto; Friedl, Alexander; Pfitzenmaier, Jesco; Naumann, Carsten M.; Wotzka, Carola; Nyarangi-Dix, Joanne; Hoffmann, Torben; Herrmann, Edwin; Obaje, Alice; Rose, Achim; Homberg, Roland; Abdunnur, Rudi; Loertzer, Hagen; Bauer, Ricarda M.; Haferkamp, Axel und Schrader, Andres J. (2019): Artificial Urinary Sphincter Cuff Size Predicts Outcome in Male Patients Treated for Stress Incontinence: Results of a Large Central European Multicenter Cohort Study. In: International Neurourology Journal, Bd. 23, Nr. 3: S. 219-225

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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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