The following is a summary of “Indications and Outcomes for Intermittent Catheterization following Bulbar AUS Cuff Placement,” published in the JANUARY 2023 issue of Urology by Krughoff, et al.

For a study, researchers sought to evaluate the functional and surgical impact of continuous, intermittent catheterization (CIC) protocols in men with a bulbar artificial urinary sphincter (AUS) in place. In addition, they aimed to determine the safety and efficacy of CIC in men with an AUS at the bulbar urethra, which remained unclear.

They conducted a retrospective review of all bulbar urethral AUS procedures at a single institution. The inclusion criteria were patients with a history of prostate cancer treatment, AUS placement for stress urinary incontinence (SUI), and a history of CIC before and/or after AUS placement. In addition, the surgical and continence outcomes were analyzed.

The study identified 57 patients who underwent AUS placement and had a history of CIC under the care of two surgeons. Among these, 18 continued to perform or initiate CIC after AUS placement, while 39 discontinued CIC before AUS placement. The incidence of erosion was not different between the patients who continued or discontinued CIC after AUS placement (17.9% vs. 22.2%, P = .79). There was also no difference in future AUS removal or replacement (56.4% vs. 44.4%, P = .41) between the two groups. However, both groups experienced an improvement in urinary incontinence after AUS placement.

The study findings suggested that bulbar AUS placement can be considered in patients who are not surgical candidates for definitive treatment of their outlet obstruction, even in continuous, intermittent catheterization. The results of the study may guide concomitant management of SUI and poor bladder emptying in men with a history of prostate cancer treatment.

Reference: goldjournal.net/article/S0090-4295(22)00899-8/fulltext