Is prolonged catheterization a risk factor for artificial urinary sphincter cuff erosion?
OBJECTIVE
To evaluate the relative risk of prolonged urethral catheterization (PC), >48 hours, on artificial urinary sphincter (AUS) cuff erosion in a tertiary referral population.


METHODS
All men who had undergone AUS implantation or revision by multiple surgeons at our institution from 2000 to 2010 with ≥6 months of follow-up were reviewed for urethral erosion, catheterization after AUS placement, and comorbid conditions.


RESULTS
Of the 258 AUS patients reviewed, 200 met the inclusion criteria, with an average follow-up of 24 months. AUS cuff erosions were noted in 24 men (12%) and were diagnosed at a mean of 16.9 months (range 0.8-87.1). PC was identified in 44 of the 200 men (22%)-of these men, erosions occurred in 17 (39%, P <.001). The indication for PC was most often major nongenitourinary surgery (36%) or urinary retention (32%). Univariate analysis identified an increased risk of erosion associated with hypertension, diabetes, coronary artery disease, PC, previous radiotherapy, and secondary AUS placement (P <.05). On multivariate analysis, only PC, radiotherapy, and revision surgery were significant (P <.05), but cuff size and concomitant inflatable penile prosthesis were not associated with AUS cuff erosion.


CONCLUSIONS
PC is an independent risk factor for AUS cuff erosion.
Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX.
Casey A
CA
Seideman
Lee C
LC
Zhao
Steven J
SJ
Hudak
Jesse
J
Mierzwiak
Mehrad
M
Adibi
Allen F
AF
Morey
D000368:Aged; D006801:Humans; D008297:Male; D011475:Prosthesis Failure / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014546:Urinary Catheterization / Q000009:adverse effects*; D016741:Urinary Sphincter, Artificial