title: Impact of 3.5 cm artificial urinary sphincter cuff on primary and revision surgery for male stress urinary incontinence.
abstract: OBJECTIVE
  We report our initial clinical experience with the new 3.5 cm artificial urinary sphincter cuff.
  
  
  METHODS
  We reviewed the records of all men who underwent artificial urinary sphincter placement done by a single surgeon since September 2009. A perineal approach was used to ensure cuff placement around the most proximal corpus spongiosum after precise spongiosal measurement with a redesigned measuring tape. Clinical factors and cuff sizes were analyzed.
  
  
  RESULTS
  During the 14-month study period 45 of 67 patients (67%) with an artificial urinary sphincter received the 3.5 cm cuff with no difference between primary and revision surgery (73% vs 58%, p = 0.29). Transcorporal cuff placement was reserved for 8 select patients (12%) after prior artificial urinary sphincter cuff erosion or complex urethroplasty. A tandem cuff artificial urinary sphincter was not used. Erectile dysfunction (89% vs 77%, p = 0.28) and prior radiation (47% vs 27%, p = 0.12) were more common in men who received a 3.5 vs a 4.0 cm or greater cuff. A similar proportion of men with a 3.5 cm vs a larger cuff (4 of 45 or 9% vs 2 of 22 or 9%) required explantation for infection and/or erosion.
  
  
  CONCLUSIONS
  At our center the 3.5 cm cuff has become the predominant size used for primary and revision artificial urinary sphincter placement. Liberal use of the 3.5 cm cuff has simplified and improved artificial urinary sphincter placement without additional morbidity.
authors.affiliation: Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas 75390-9110, USA.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Hudak
authors.forename: Allen F
authors.initials: AF
authors.lastname: Morey
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001284:Atrophy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000009:adverse effects; D011474:Prosthesis Design; D012086:Reoperation; D012189:Retrospective Studies; D014521:Urethra / Q000473:pathology; D014550:Urinary Incontinence, Stress / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D016741:Urinary Sphincter, Artificial; D014563:Urodynamics