[Therapeutic effect on postoperative complications of male artificial urethral sphincter implantation]

Abstract

A retrospective study was conducted on the clinical data of male patients who developed complications after artificial urethral sphincter (AUS) implantation at Beijing Hospital from March 2019 to December 2024. The study evaluated the occurrence, management, and outcomes of these complications. Among the 72 patients who underwent AUS implantation, 10 patients (13.9%), aged 27-85 (64.9±19.4) years old, experienced complications following AUS implantation. Two patients developed painless gross hematuria, which improved after symptomatic treatment. Two patients involved control pump erosion through the skin, leading to device exposure, and were treated with debridement and revision surgery while retaining the AUS device. Among the five patients with urethral erosion, different surgical methods were selected according to the degree of urethral defect: three underwent device removal+partial urethral resection+termino-terminal anastomosis, one underwent cuff removal+urethral repair, and one underwent device removal+partial urethral resection+mucosal transplantation+cystostomy. One patient experienced mechanical failure (system leakage) and underwent AUS replacement surgery. All patients were followed up for [M (Q₁, Q₃)] 5.5 (2.3, 37.5) months. No recurrence of hematuria was observed. Patients with device exposure and mechanical failure achieved social continence, while patients with urethral erosion returned to persistent incontinence. No surgery-related complications occurred. Early identification, accurate diagnosis, and appropriate management are key to diagnosing and treating AUS postoperative complications.