Terlecki, R.

Artificial urinary sphincter, Capsulotomy, Urethral atrophy, Urinary incontinence

The video discusses an alternative etiology for recurrent stress urinary incontinence (rSUI) after artificial urinary sphincter (AUS) placement. We include three patient scenarios in this video. All patients had a history of prostate cancer treated with radical prostatectomy with subsequent AUS placement for recurrent stress urinary incontinence. We present a novel technique of subcuff capsule incision and pressure regulating balloon (PRB) interrogation. Although a urethra may appear atrophied due to a constricted appearance below a previously placed AUS cuff, our data suggest that subcuff capsulotomy results in restoration of urethral circumference and that placing a similarly sized cuff relative to that of initial placement after capsulotomy can provide proper occlusion. Intraoperative interrogation of the PRB also demonstrates mild material fatigue.

 Ryan Terlecki is a consultant for and receives grant funding from American Medical Systems/Boston Scientific