Open Access

HOW I DO IT

Urethral bulking with native tissue during artificial urinary sphincter surgery

Matthew J. Rabinowitz, James L. Liu, Jason A. Levy, William DuComb, Arthur L. Burnett

The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
Address correspondence to Dr. Arthur L. Burnett, 600 N. Wolfe Street, Baltimore, MD 21287 USA

Canadian Journal of Urology 2023, 30(2), 11516-11519.

Abstract

The artificial urinary sphincter (AUS) is the “gold standard” surgical treatment for severe stress urinary incontinence. However, a subset of patients with frail urethras may require technical adjuncts to ensure optimal cuff function. Our objective is to provide a detailed tutorial of our institution’s method for performing urethral bulking with native tissue in patients with frail urethras during AUS surgery. We have found that urethral bulking with native tissue provides a cost-efficient and durable technique for improved AUS cuff coaptation. Our experience demonstrates adequate short and intermediate term efficacy with limited complications. These techniques equip surgeons with an alternative surgical approach for appropriate patients receiving AUS surgery who have been previously exposed to pelvic radiation and/or significant surgical morbidity resulting in frail urethral tissue.

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