title: The Ohmmeter Identifies the Site of Fluid Leakage during Artificial Urinary Sphincter Revision Surgery.
abstract: OBJECTIVE
  While the AMS 800 artificial urinary sphincter improves continence in up to 90% of patients, revision surgery may be needed in up to 50%. We determined whether an ohmmeter could accurately assess the site of fluid leak from individual components of the artificial urinary sphincter at the time of revision surgery.
  
  
  METHODS
  We retrospectively reviewed the records of patients who underwent artificial urinary sphincter revision surgery between 1996 and 2013. Patients in whom fluid loss was identified preoperatively by plain film radiography and who subsequently underwent revision surgery using the ohmmeter were assessed for outcomes.
  
  
  RESULTS
  The ohmmeter was used intraoperatively in a total of 20 surgeries in 19 patients and it correctly identified the location of fluid loss in 18 of 20 (90%). Fluid leakage was found from the pressure regulating balloon in 13 cases, from the cuff in 4 and from the tubing to the pressure regulating balloon in 1. None had fluid loss from the pump. In the 17 cases in which only the malfunctioning component was replaced a satisfactory postoperative outcome with a fully functional device was documented in all. Repeat surgery was performed in 5 of 17 cases (29.4%) at a median of 17 months (range 2 to 39). No patient underwent repeat surgery due to failure to accurately diagnose a component leak.
  
  
  CONCLUSIONS
  In cases of suspected fluid loss as a cause of artificial urinary sphincter malfunction an ohmmeter can identify the site of fluid loss during component revision surgery.
authors.affiliation: Divisions of Urology and Reconstructive Urology, Duke University Medical Center, Durham, North Carolina; Department of Urology, University of Kentucky (SG), Lexington, Kentucky. Electronic address: Patrick.selph@duke.edu.
authors.forename: John Patrick
authors.initials: JP
authors.lastname: Selph
authors.affiliation: Divisions of Urology and Reconstructive Urology, Duke University Medical Center, Durham, North Carolina; Department of Urology, University of Kentucky (SG), Lexington, Kentucky.
authors.forename: Michael James
authors.initials: MJ
authors.lastname: Belsante
authors.affiliation: Divisions of Urology and Reconstructive Urology, Duke University Medical Center, Durham, North Carolina; Department of Urology, University of Kentucky (SG), Lexington, Kentucky.
authors.forename: Shubham
authors.initials: S
authors.lastname: Gupta
authors.affiliation: Divisions of Urology and Reconstructive Urology, Duke University Medical Center, Durham, North Carolina; Department of Urology, University of Kentucky (SG), Lexington, Kentucky.
authors.forename: Divya
authors.initials: D
authors.lastname: Ajay
authors.affiliation: Divisions of Urology and Reconstructive Urology, Duke University Medical Center, Durham, North Carolina; Department of Urology, University of Kentucky (SG), Lexington, Kentucky.
authors.forename: Aaron
authors.initials: A
authors.lastname: Lentz
authors.affiliation: Divisions of Urology and Reconstructive Urology, Duke University Medical Center, Durham, North Carolina; Department of Urology, University of Kentucky (SG), Lexington, Kentucky.
authors.forename: George
authors.initials: G
authors.lastname: Webster
authors.affiliation: Divisions of Urology and Reconstructive Urology, Duke University Medical Center, Durham, North Carolina; Department of Urology, University of Kentucky (SG), Lexington, Kentucky.
authors.forename: Ngoc-Bich P
authors.initials: NB
authors.lastname: Le
authors.affiliation: Divisions of Urology and Reconstructive Urology, Duke University Medical Center, Durham, North Carolina; Department of Urology, University of Kentucky (SG), Lexington, Kentucky.
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Peterson
mesh_terms: D017097:Electric Impedance; D006801:Humans; D008297:Male; D011468:Prostatectomy / Q000009:adverse effects; D011475:Prosthesis Failure; D012086:Reoperation; D012189:Retrospective Studies; D014549:Urinary Incontinence / Q000209:etiology / Q000601:surgery*; D016741:Urinary Sphincter, Artificial
keywords: artificial; prosthesis failure; reoperation; urethra; urinary incontinence; urinary sphincter