Salvage surgical procedure for artificial sphincter extrusion

Vol. 44 (3): 634-638, May – June, 2018

doi: 10.1590/S1677-5538.IBJU.2017.0462


CHALLENGING CLINICAL CASES

Flavio Trigo Rocha 1, Jean Felipe Prodocimo Lesting 1
1 Centro de Incontinência Urinaria, Hospital Sírio Libanês, SP, Brasil

ABSTRACT

Case Hypothesis: Surgical removal is the standard treatment for artificial sphincter extrusion. However in some specific situations is possible to maintain the prosthesis with good results.

Case report: We report a 60 years old patient presenting sphincter pump extrusion one month after artificial urinary sphincter (AUS) AMS 800™ placement for treating post-radical prostatectomy urinary incontinence (PRPUI). He also had a penile prosthesis implant one year before that was replaced in the same surgery the sphincter was implanted. As patient refused sphincter removal and there were no signals of active infection he was treated by extensive surgical washing with antibiotics and antiseptics.

Pump was repositioned in the opposite side of the scrotum. Patient had good evolution with sphincter activation 50 days later. After 10 months of follow up, patient is socially continent and having regular sexual intercourse. Savage surgery may be an option in select cases of artificial sphincter extrusion.

Promising future implications: Like in some patients with penile prosthesis some patients with artificial sphincter extrusion can be treated without removing the device.

This may be a line of research about conservative treatment of artificial sphincter complications.

Keywords: Urinary Incontinence; Surgical Procedures, Operative; Urinary Sphincter, Artificial

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