Advertisement

Reoperative Anti-incontinence Surgery

  • Brian J. Linder
  • Daniel S. ElliottEmail author
Chapter
  • 454 Downloads

Abstract

Reoperative anti-incontinence surgery can be a challenging clinical entity. A thorough evaluation of persistent or recurrent urinary incontinence, including a history, physical exam, and additional diagnostic testing is needed to determine the onset and severity of leakage, previous treatments, contributing etiologies and health of the underlying urethral tissue. With regard to technique, repeat anti-incontinence surgery ranges from cases with near standard anatomy and easily identifiable tissues that differ little from the original operation, to those with obliterated tissue planes, as in the setting of previous radiation or extensive tissue destruction from prior dissection and local infections. Here in, we present a stepwise approach to management of the most common scenarios for repeat anti-incontinence surgery.

Keywords

Urinary incontinence Artificial urinary sphincter Urethral sling Revision Device infection Failure 

References

  1. 1.
    Van Der Aa F, Drake MJ, Kasyan GR, Petrolekas A. The artificial urinary sphincter after a quarter of a century: a critical systematic review of its use in male non-neurogenic incontinence. Eur Urol. 2013;63:681–9.CrossRefPubMedGoogle Scholar
  2. 2.
    Trost L, Elliott DS. Male stress urinary incontinence: a review of surgical treatment options and outcomes. Adv Urol. 2012;2012:287489.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Gormley EA, Lightner DJ, Burgio KL, et al. Diagnosis and treatment of overactive bladder (non-neurogenic) in adults: AUA/SUFU guideline. J Urol. 2012;188:2455–63.CrossRefPubMedGoogle Scholar
  4. 4.
    Petrou SP, Williams HJJR, Young PR. Radiographic imaging of the artificial urinary sphincter pressure regulating balloon. J Urol. 2001;165:1773–5.CrossRefPubMedGoogle Scholar
  5. 5.
    Brucker BM, Demirtas A, Fong E, Kelly C, Nitti VW. Artificial urinary sphincter revision: the role of ultrasound. Urology. 2013;82:1424–8.CrossRefPubMedGoogle Scholar
  6. 6.
    Wang R, McGuire EJ, He C, Faerber GJ, Latini JM. Long-term outcomes after primary failures of artificial urinary sphincter implantation. Urology. 2012;79:922–8.CrossRefPubMedGoogle Scholar
  7. 7.
    Lai HH, Hsu EI, Teh BS, Butler EB, Boone TB. 13 years of experience with artificial urinary sphincter implantation at Baylor College of Medicine. J Urol. 2007;177:1021–5.CrossRefPubMedGoogle Scholar
  8. 8.
    Jura YH, Comiter CV. Urodynamics for postprostatectomy incontinence: when are they helpful and how do we use them? Urol Clin North Am. 2014;41:419–27.CrossRefPubMedGoogle Scholar
  9. 9.
    Bauer RM, Gozzi C, Roosen A, et al. Impact of the “repositioning test” on postoperative outcome of retroluminar transobturator male sling implantation. Urol Int. 2013;90:334–8.CrossRefPubMedGoogle Scholar
  10. 10.
    Linder BJ, de Cogain M, Elliott DS. Long-term device outcomes of artificial urinary sphincter reimplantation following prior explantation for erosion or infection. J Urol. 2014;191:734–8.CrossRefPubMedGoogle Scholar
  11. 11.
    Kim SP, Sarmast Z, Daignault S, Faerber GJ, McGuire EJ, Latini JM. Long-term durability and functional outcomes among patients with artificial urinary sphincters: a 10-year retrospective review from the University of Michigan. J Urol. 2008;179:1912–6.CrossRefPubMedGoogle Scholar
  12. 12.
    Tuygun C, Imamoglu A, Gucuk A, Goktug G, Demirel F. Comparison of outcomes for adjustable bulbourethral male sling and artificial urinary sphincter after previous artificial urinary sphincter erosion. Urology. 2009;73:1363–7.CrossRefPubMedGoogle Scholar
  13. 13.
    Christine B, Knoll LD. Treatment of recurrent urinary incontinence after artificial urinary sphincter placement using the AdVance male sling. Urology. 2010;76:1321–4.CrossRefPubMedGoogle Scholar
  14. 14.
    Tuygun C, Imamoglu A, Keyik B, Alisir I, Yorubulut M. Significance of fibrosis around and/or at external urinary sphincter on pelvic magnetic resonance imaging in patients with postprostatectomy incontinence. Urology. 2006;68:1308–12.CrossRefPubMedGoogle Scholar
  15. 15.
    Raj GV, Peterson AC, Toh KL, Webster GD. Outcomes following revisions and secondary implantation of the artificial urinary sphincter. J Urol. 2005;173:1242–5.CrossRefPubMedGoogle Scholar
  16. 16.
    Webster GD, Sherman ND. Management of male incontinence following artificial urinary sphincter failure. Curr Opin Urol. 2005;15:386–90.CrossRefPubMedGoogle Scholar
  17. 17.
    Saffarian A, Walsh K, Walsh IK, Stone AR. Urethral atrophy after artificial urinary sphincter placement: is cuff downsizing effective? J Urol. 2003;169:567–9.CrossRefPubMedGoogle Scholar
  18. 18.
    Hudak SJ, Morey AF. Impact of 3.5 cm artificial urinary sphincter cuff on primary and revision surgery for male stress urinary incontinence. J Urol. 2011;186:1962–6.CrossRefPubMedGoogle Scholar
  19. 19.
    Simhan J, Morey AF, Singla N, et al. 3.5 cm artificial urinary sphincter cuff erosion occurs predominantly in radiated patients. J Urol. 2014. doi: 10.1016/j.juro.2014.07.115.Google Scholar
  20. 20.
    Guralnick ML, Miller E, Toh KL, Webster GD. Transcorporal artificial urinary sphincter cuff placement in cases requiring revision for erosion and urethral atrophy. J Urol. 2002;167:2075–8.CrossRefPubMedGoogle Scholar
  21. 21.
    Brito CG, Mulcahy JJ, Mitchell ME, Adams MC. Use of a double cuff AMS800 urinary sphincter for severe stress incontinence. J Urol. 1993;149:283–5.PubMedGoogle Scholar
  22. 22.
    Magera JS, Elliott DS. Tandem transcorporal artificial urinary sphincter cuff salvage technique: surgical description and results. J Urol. 2007;177:1015–9.CrossRefPubMedGoogle Scholar
  23. 23.
    DiMarco DS, Elliott DS. Tandem cuff artificial urinary sphincter as a salvage procedure following failed primary sphincter placement for the treatment of post-prostatectomy incontinence. J Urol. 2003;170:1252–4.CrossRefPubMedGoogle Scholar
  24. 24.
    O’Connor RC, Lyon MB, Guralnick ML, Bales GT. Long-term follow-up of single versus double cuff artificial urinary sphincter insertion for the treatment of severe postprostatectomy stress urinary incontinence. Urology. 2008;71:90–3.CrossRefPubMedGoogle Scholar
  25. 25.
    Kowalczyk JJ, Spicer DL, Mulcahy JJ. Erosion rate of the double cuff AMS800 artificial urinary sphincter: long-term followup. J Urol. 1996;156:1300–1.CrossRefPubMedGoogle Scholar
  26. 26.
    Trost L, Elliott D. Small intestinal submucosa urethral wrap at the time of artificial urinary sphincter placement as a salvage treatment option for patients with persistent/recurrent incontinence following multiple prior sphincter failures and erosions. Urology. 2012;79:933–8.CrossRefPubMedGoogle Scholar
  27. 27.
    Rahman NU, Minor TX, Deng D, Lue TF. Combined external urethral bulking and artificial urinary sphincter for urethral atrophy and stress urinary incontinence. BJU Int. 2005;95:824–6.CrossRefPubMedGoogle Scholar
  28. 28.
    Chung E, Cartmill R. Diagnostic challenges in the evaluation of persistent or recurrent urinary incontinence after artificial urinary sphincter (AUS) implantation in patients after prostatectomy. BJU Int. 2013;112:32–5.CrossRefGoogle Scholar
  29. 29.
    Lai HH, Boone TB. Complex artificial urinary sphincter revision and reimplantation cases--how do they fare compared to virgin cases? J Urol. 2012;187:951–5.CrossRefPubMedGoogle Scholar
  30. 30.
    Elliott DS, Barret DM. Mayo clinic long-term analysis of the functional durability of the AMS 800 artificial urinary sphincter: a review of 323 cases. J Urol. 1998;159:1206–8.CrossRefPubMedGoogle Scholar
  31. 31.
    Montague DK, Angermeier KW. Artificial urinary sphincter troubleshooting. Urology. 2001;58:779–82.CrossRefPubMedGoogle Scholar
  32. 32.
    Magera JS, Elliott DS. Artificial urinary sphincter infection: causative organisms in a contemporary series. J Urol. 2008;180:2475–8.CrossRefPubMedGoogle Scholar
  33. 33.
    Kowalczyk JJ, Nelson R, Mulcahy JJ. Successful reinsertion of the artificial urinary sphincter after removal for erosion or infection. Urology. 1996;48:906–8.CrossRefPubMedGoogle Scholar
  34. 34.
    Flynn BJ, Webster GD. Evaluation and surgical. Rev Urol. 2004;6:180–6.PubMedPubMedCentralGoogle Scholar
  35. 35.
    Rozanski AT, Tausch TJ, Ramirez D, Simhan J, Scott JF, Morey AF. Immediate urethral repair during explantation prevents stricture formation after artificial urinary sphincter cuff erosion. J Urol. 2014;192(2):442–6.CrossRefPubMedGoogle Scholar
  36. 36.
    Bryan DE, Mulcahy JJ, Simmons GR. Salvage procedure for infected noneroded artificial urinary sphincters. J Urol. 2002;168:2464–6.CrossRefPubMedGoogle Scholar
  37. 37.
    Wiedemann L, Cornu J-N, Haab E, et al. Transcorporal artificial urinary sphincter implantation as a salvage surgical procedure for challenging cases of male stress urinary incontinence: surgical technique and functional outcomes in a contemporary series. BJU Int. 2013;112:1163–8.CrossRefPubMedGoogle Scholar
  38. 38.
    Frank I, Elliott DS, Barrett DM. Success of de novo reimplantation of the artificial genitourinary sphincter. J Urol. 2000;163:1702–3.CrossRefPubMedGoogle Scholar
  39. 39.
    Raj GV, Peterson AC, Webster GD. Outcomes following erosions of the artificial urinary sphincter. J Urol. 2006;175:2186–90. discussion 2190.CrossRefPubMedGoogle Scholar
  40. 40.
    Elliott DS, Barrett DM, Gohma M, Boone TB. Does nocturnal deactivation of the artificial urinary sphincter lessen the risk of urethral atrophy? Urology. 2001;57:1051–4.CrossRefPubMedGoogle Scholar
  41. 41.
    Kumar A, Litt ER, Ballert KN, Nitti VW. Artificial urinary sphincter versus male sling for post-prostatectomy incontinence—what do patients choose? J Urol. 2009;181:1231–5.CrossRefPubMedGoogle Scholar
  42. 42.
    Lentz AC, Peterson AC, Webster GD. Outcomes following artificial sphincter implantation after prior unsuccessful male sling. J Urol. 2012;187:2149–53.CrossRefPubMedGoogle Scholar
  43. 43.
    Fisher MB, Aggarwal N, Vuruskan H, Singla AK. Efficacy of artificial urinary sphincter implantation after failed bone-anchored male sling for postprostatectomy incontinence. Urology. 2007;70:942–4.CrossRefPubMedGoogle Scholar
  44. 44.
    Abdou A, Cornu J-N, Sèbe P, et al. Salvage therapy with artificial urinary sphincter after Advance™ male sling failure for post-prostatectomy incontinence: a first clinical experience. Prog Urol. 2012;22:650–6.CrossRefPubMedGoogle Scholar
  45. 45.
    Soljanik I, Becker AJ, Stief CG, Gozzi C, Bauer RM. Repeat retrourethral transobturator sling in the management of recurrent postprostatectomy stress urinary incontinence after failed first male sling. Eur Urol. 2010;58:767–72.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Department of UrologyMayo ClinicRochesterUSA

Personalised recommendations