less than 0.1 mm mean difference (p <0.0001). The cuff size chosen was between 4 and 5.5 cm with 47% of the cuffs chosen being 4.5 cm. There was no significant difference in the measurements of circumference without a catheter, with a 12 or 16 French catheter in place (p<0.0001) suggesting that final cuff size was not influenced by the presence or absence of a urethral catheter.CONCLUSIONS: The presence of a urethral catheter does not influence circumferential measurement during AUS implantation. Because of this, we no longer routinely remove the catheter during the measuring portion of the procedure. We feel that minimizing catheter manipulation will potentially translate into decreased complication rates due to decreased length of the procedure and decreased exposure of the implant.
The majority of patients undergoing insertion of an artificial urinary sphincter (AUS) are discharged with a course of oral antibiotics postoperatively. This practice is not supported by the literature and may be unwise in the context of increasing antibiotic resistance worldwide. We sought to determine if patients discharged without antibiotics after AUS insertion were more likely to require device explantation for infection or erosion compared to patients discharged with antibiotics at our institution and compared to patients in other large, contemporary series.METHODS: Electronic medical records of patients who underwent AUS insertion between 2013 and 2017 were retrospectively reviewed to determine demographics, comorbidities, and perioperative and medium-term outcomes. Patients were grouped based on known risk factors for infectious complications or erosion (diabetes, prostate radiation, prior AUS explant, chronic steroid use, 3.5 cm cuff size, the presence of a penile prosthesis at time of AUS insertion, prior urethral stent placement, and prior urethroplasty) and postoperative antibiotic prescription status. Patients were placed in Group 1 if they did not demonstrate risk factors and did not receive postoperative antibiotics, Group 2 if they did possess risk factors but did not receive postoperative antibiotics, and Group 3 if they had risk factors and received postoperative antibiotics.RESULTS: Of the 155 men who met inclusion criteria, 44, 47, and 64 were categorized in Groups 1, 2, and 3, respectively. Median (IQR) follow up was similar across Groups 1, 2, and 3 (12.
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