LAUSR

INTRODUCTION AND OBJECTIVE: Although transcorporal (TC) placement of artificial urinary sphincter (AUS) has traditionally been used as a protective strategy in patients at risk for urethral erosion, long-term comparative outcomes have been sparsely reported. We evaluated anatomical characteristics of TC and standard (ST) placement AUS cuff erosions in order to compare their erosion patterns. METHODS: We performed a retrospective review of men who presented with AUS erosion treated by a single surgeon between 2007 and 2019 at a tertiary medical center. We compared the anatomical characteristics of erosions in patients who had TC versus ST AUS placement. TC indications included complications of prior antiincontinence procedures and prior urethral reconstruction. RESULTS: Of 723 patients who underwent AUS surgery, we identified 55 (7.6%) patients who sustained cuff erosions. Erosion developed in 15/82 (18.3%) men with TC AUS and 40/641 (6.24%) patients with ST AUS (p[0.005). AUS cuff erosions occurred predominantly ventrally in both groups (66.67% for TC and 77.5% for ST AUS, p[0.75) followed by lateral urethral location (33.3% TC and 15% ST, p[0.13). Dorsal erosions were rare in both groups (TC 20%, ST 5%, p[0.08). History of radiation, prior urethroplasty, and history of prior erosion were more often associated with TC AUS erosion. There were no differences in terms of hypogonadal status, comorbidities, or AUS cuff size. CONCLUSIONS: AUS cuff erosions appear to occur ventrally in most patients regardless of cuff placement. Dorsal erosions were the least common in both groups, casting doubt on the protective effect of the TC cuff strategy.