Most men with artificial urinary sphincter cuff erosion have low serum testosterone levels. Issue 4 (1st April 2021)

• Record Type: Journal Article
• Authors: Wolfe, Avery R.; Ortiz, Nicolas M.; Baumgarten, Adam S.; VanDyke, Maia E.; West, Mary L.; Dropkin, Benjamin M.; Joice, Gregory A.; Sanders, Sarah C.; Hudak, Steven J.; Morey, Allen F.
• Is Part Of: Neurourology and urodynamics. Volume 40:Issue 4(2021)
• Page Start: 1035
• Page End: 1041
• Publication Date: 2021-04-01
• Subjects: artificial urinary sphincter -- hypogonadism -- stress urinary incontinence -- urethral erosion; Urinary organs -- Periodicals; Urodynamics -- Periodicals; Urology -- Periodicals; 616.6
• DOI: 10.1002/nau.24663
• Languages: English
• ISSNs: 0733-2467

Abstract

Abstract: Aims: To evaluate the relationship between serum testosterone (T) levels and artificial urinary sphincter (AUS) cuff erosion in a population of incontinent men who underwent AUS placement. Methods: A retrospective analysis of our single‐surgeon AUS database was performed to identify men with T levels within 24 months of AUS placement. Men were stratified into two groups based on serum testosterone: low serum testosterone (LT) (<280 ng/dl) and normal serum testosterone (NT) (>280 ng/dl). Multivariable analysis was performed to control for risk factors. The outcome of interest was the incidence of and time to spontaneous urethral cuff erosion; other risk factors for cuff erosion were also evaluated. Results: Among 161 AUS patients with serum testosterone levels, 84 (52.2%) had LT (mean: 136.8 ng/dl, SD : 150.4 ng/dl) and 77 (47.8%) had NT (mean: 455.8 ng/dl, SD : 197.3 ng/dl). Cuff erosion was identified in 42 men (26.1%) at a median of 7.1 months postoperatively (interquartile range: 3.6–13.4 months), most of whom (30/42, 71.4%) were testosterone deficient. LT levels were less common (54/119, 45.4%) in the non‐erosion cohort ( p = 0.004). Men with low T were nearly three times as likely to suffer AUS erosion than men with normal T (odds ratio = 2.519, p = 0.021). LT level was the only factor associated with AUS erosion on multivariable analysis. Conclusions: LT is an independent risk factor for AUS cuff erosion. Men with LT are more likely to present with cuff erosion, but there is no difference in time to erosion.