title: Low Serum Testosterone Level Predisposes to Artificial Urinary Sphincter Cuff Erosion.
abstract: OBJECTIVE
  To examine the association between decreased serum testosterone levels and artificial urinary sphincter (AUS) cuff erosion.
  
  
  METHODS
  We evaluated serum testosterone levels in 53 consecutive patients. Low testosterone was defined as <280 ng/dL and found in 30/53 patients (56.6%). Chi-square and Student t tests, Kaplan-Meier analysis, binary logistic regression, and Cox regression analysis were used to determine statistical significance.
  
  
  RESULTS
  Nearly all men with AUS cuff erosions had low serum testosterone (18/20, 90.0%) compared to those without erosions (12/33, 36.4%, P < .001). Mean time to erosion was 1.70 years (0.83-6.86); mean follow-up was 2.76 years (0.34-7.92). Low testosterone had a hazard ratio of 7.15 for erosion in a Cox regression analysis (95% confidence interval 1.64-31.17, P = .009) and Kaplan-Meier analysis demonstrated decreased erosion-free follow-up (log-rank P = .002). Low testosterone was the sole independent risk factor for erosion in a multivariable model including coronary artery disease and radiation (odds ratio 15.78; 95% confidence interval 2.77-89.92, P = .002). Notably, history of prior AUS, radiation, androgen ablation therapy, or concomitant penile implant did not confound risk of cuff erosion in men with low testosterone levels.
  
  
  CONCLUSIONS
  Men with low testosterone levels are at a significantly higher risk to experience AUS cuff erosion. Appropriate counseling before AUS implantation is warranted and it is unclear whether testosterone resupplementation will mitigate this risk.
authors.affiliation: Department of Urology, UT Southwestern Medical Center, Dallas, TX.
authors.forename: Matthias D
authors.initials: MD
authors.lastname: Hofer
authors.affiliation: Department of Urology, UT Southwestern Medical Center, Dallas, TX. Electronic address: allen.morey@utsouthwestern.edu.
authors.forename: Allen F
authors.initials: AF
authors.lastname: Morey
authors.affiliation: Department of Urology, UT Southwestern Medical Center, Dallas, TX.
authors.forename: Kunj
authors.initials: K
authors.lastname: Sheth
authors.affiliation: Department of Urology, UT Southwestern Medical Center, Dallas, TX.
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Tausch
authors.affiliation: Department of Urology, UT Southwestern Medical Center, Dallas, TX.
authors.forename: Jordan
authors.initials: J
authors.lastname: Siegel
authors.affiliation: Department of Urology, UT Southwestern Medical Center, Dallas, TX.
authors.forename: Billy H
authors.initials: BH
authors.lastname: Cordon
authors.affiliation: Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL.
authors.forename: Matthew I
authors.initials: MI
authors.lastname: Bury
authors.affiliation: Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL.
authors.forename: Earl Y
authors.initials: EY
authors.lastname: Cheng
authors.affiliation: Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL.
authors.forename: Arun K
authors.initials: AK
authors.lastname: Sharma
authors.affiliation: Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL.
authors.forename: Chris M
authors.initials: CM
authors.lastname: Gonzalez
authors.affiliation: Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL.
authors.forename: William E
authors.initials: WE
authors.lastname: Kaplan
authors.affiliation: Department of Urology, UT Southwestern Medical Center, Dallas, TX.
authors.forename: Nicholas L
authors.initials: NL
authors.lastname: Kavoussi
authors.affiliation: Department of Urology, UT Southwestern Medical Center, Dallas, TX.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Klein
authors.affiliation: Department of Urology, UT Southwestern Medical Center, Dallas, TX.
authors.forename: Claus G
authors.initials: CG
authors.lastname: Roehrborn
mesh_terms: D000368:Aged; D003324:Coronary Artery Disease / Q000150:complications; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011468:Prostatectomy / Q000009:adverse effects; D011471:Prostatic Neoplasms / Q000628:therapy*; D011475:Prosthesis Failure / Q000209:etiology; D011878:Radiotherapy / Q000009:adverse effects; D012307:Risk Factors; D013739:Testosterone / Q000097:blood / Q000172:deficiency*; D014550:Urinary Incontinence, Stress / Q000209:etiology / Q000601:surgery; D016741:Urinary Sphincter, Artificial
chemical_list: D013739:Testosterone