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Pressure regulating balloon herniation: A correctable cause of artificial urinary sphincter malfunction

Urology Feb 17, 2020

Khouri RK, Baumgarten AS, Ortiz NM, et al. - Investigators describe their experience with isolated pressure-regulating balloon (PRB) replacement for artificial urinary sphincter (AUS) malfunction in the setting of PRB herniation. A retrospective review of the large single-surgeon male AUS database was performed to include a total of 725 individuals who underwent AUS surgery between 2011-2019. They examined men with herniated PRBs palpable in the groin within an otherwise intact system. The study found significant improvement in 94.7% of individuals (18/19) with their SUI, and 78.9% of individuals (15/19) achieved continence at a mean follow up of 21.7 months (range 2-99 months). Thirteen months (IQR 6-34 months) were the median time between AUS placement and PRB revision. The data showed that PRB replacement seems to be a safe and effective salvage therapy for AUS individuals with PRB herniation and persistent incontinence without mechanical failure. It was indicated that intraoperative cystoscopic confirmation of improved sphincter coaptation seems to be a reliable predictor of treatment success.
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