title: Urethral Stricture Outcomes After Artificial Urinary Sphincter Cuff Erosion: Results From a Multicenter Retrospective Analysis.
abstract: OBJECTIVE
  To evaluate the influence of both repair type and degree of cuff erosion on postoperative urethral stricture rate. Sparse literature exists regarding patient outcomes after artificial urinary sphincter (AUS) cuff erosion. Surgeons from 6 high-volume male continence centers compiled a comprehensive database of post-erosion patients to examine outcomes.
  
  
  METHODS
  This retrospective multi-institution study included 80 patients treated for AUS cuff erosions. Seventy-eight patients had specific information regarding post-cuff erosion urethral strictures. Erosion patients were categorized into 1 of 3 repair types at the time of explant surgery: catheter only, single-layer capsule-to-capsule repair (urethrorrhaphy), and formal urethroplasty. Operative notes and available medical records were extensively reviewed to collect study data.
  
  
  RESULTS
  Twenty-five of 78 patients manifested a urethral stricture after AUS cuff erosion (32%). More strictures occurred among patients who underwent urethrorrhaphy (40% vs 29% for catheter only and 14% for urethroplasty). Stricture rates did not vary significantly by repair type (P = .2). Strictures occurred significantly more frequently in patients with complete cuff erosions (58%) as compared to partial erosions (25%, P = .037). A trend was detected regarding increased percentage of erosion correlating with increased stricture rate, but this did not reach statistical significance (P = .057). Partially eroded patients were more likely to undergo urethrorrhaphy repair (60%, P = .002).
  
  
  CONCLUSIONS
  Urethral stricture was more likely to occur after complete cuff erosion as opposed to partial erosion in this multicenter retrospective population. Repair type, whether catheter only, urethrorrhaphy, or formal urethroplasty, did not appear to influence postoperative stricture rate.
authors.affiliation: Dartmouth-Hitchcock Medical Center, Lebanon, NH. Electronic address: martin.s.gross@gmail.com.
authors.forename: Martin S
authors.initials: MS
authors.lastname: Gross
authors.affiliation: University of Kansas Medical Center, Kansas City, KS.
authors.forename: Joshua A
authors.initials: JA
authors.lastname: Broghammer
authors.affiliation: Vanderbilt University Medical Center, Nashville, TN.
authors.forename: Melissa R
authors.initials: MR
authors.lastname: Kaufman
authors.affiliation: Vanderbilt University Medical Center, Nashville, TN.
authors.forename: Douglas F
authors.initials: DF
authors.lastname: Milam
authors.affiliation: University of Utah Hospital, Salt Lake City, UT.
authors.forename: William O
authors.initials: WO
authors.lastname: Brant
authors.affiliation: University of Arkansas for Medical Sciences, Little Rock, AR.
authors.forename: Mario A
authors.initials: MA
authors.lastname: Cleves
authors.affiliation: University of Kansas Medical Center, Kansas City, KS.
authors.forename: Travis W
authors.initials: TW
authors.lastname: Dum
authors.affiliation: Central Ohio Urology Group, Gahanna, OH.
authors.forename: Christopher
authors.initials: C
authors.lastname: McClung
authors.affiliation: Urology San Antonio, San Antonio, TX.
authors.forename: LeRoy A
authors.initials: LA
authors.lastname: Jones
authors.affiliation: Florida Urology Associates, Orlando, FL.
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Brady
authors.affiliation: Urology Center of Spartanburg, Spartanburg, SC.
authors.forename: Michael B
authors.initials: MB
authors.lastname: Pryor
authors.affiliation: Regional Urology, Shreveport, LA.
authors.forename: Gerard D
authors.initials: GD
authors.lastname: Henry
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004260:DNA Repair; D020878:Device Removal; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011184:Postoperative Period; D011475:Prosthesis Failure; D012189:Retrospective Studies; D012307:Risk Factors; D014521:Urethra / Q000601:surgery*; D014525:Urethral Stricture / Q000628:therapy*; D016741:Urinary Sphincter, Artificial / Q000009:adverse effects*; D013520:Urologic Surgical Procedures; D055815:Young Adult