AUS with stricture

[SimplyT]

Any one with experience or info with having artificial sphincter surgery while dealing with an urethral stricture as a result of radiation cystitis and other invasive procedures?

Thinking of AUS but concerned with results due to my urethral stricture issues.

Thanks

[Tall_Allen]

I've never heard of AUS used for men who have a urethral stricture, only for incontinence. They are opposite problems. Did a urologist recommend it?

[SimplyT in reply to Tall_Allen]

It’s for incontinence but there was some discussion that it could possibly benefit existing scar tissue. I’m concerned it could make the stricture worse. I was hoping someone might be dealing with a similar issue.

[SimplyT in reply to Tall_Allen]

Yes, urologist said it might could benefit me with stricture, I hope to have another consultation soon. Thanks for your reply.

[RMontana]

I had early salvage radiation following surgery but did not suffer any side effects. I am going to get my consultation for a AUS implant tomorrow. I am inconsistent n use multiple pads per day. I did some research and here is what I found. Read up on the references and see if this makes sense to you.

If you already have strictures from what I read you may have fewer years of success with the implant and are more likely to have explant or removal of the device. I would also ask if my condition could actually be worse if the removal was for erosion or atrophy. But check it out for yourself.

1. AUS effectiveness over time for Initial implants; pmc.ncbi.nlm.nih.gov/articl...

> “While 36% and 23% of patients 5–10 years out from surgery and >10 years out from surgery, respectively, reported using a security pad or less per day, 78% and 81% of those patients, respectively, reported their PGI-I as at least “much better”.

Bulbar Urethra: This is the most common location for AUS cuff placement in men.

However, radiation can make this area more susceptible to complications.

Transcorporal Approach: Often recommended for patients with a history of radiation therapy.

This technique involves placing the cuff partially through the corpora cavernosa.

It's used in cases of urethral atrophy or prior radiation to provide additional tissue support.

2 AUS complications; pubmed.ncbi.nlm.nih.gov/261...

> Results: Patients undergoing AUS implantation had a median age of 71 years (interquartile range 66-76) and median follow-up of 4.1 years (interquartile range 0.8-7.7). Overall, 338 of 1082 patients (31.2%) underwent secondary surgery, including 89 for device infection and/or erosion, 131 for device malfunction, 89 for urethral atrophy, and 29 for pump malposition or tubing complications.

[SimplyT in reply to RMontana]

Thank you for this information

[awb1]

I have radiation cystitis and proctitis due to primary proton beam radiation and salvage brachytherapy, 20 and 17 years ago.  I was referred to HBOT and have completed more than half of 40 sessions.  At this point, I perceive remarkable improvement in the chronic urgency symptoms. HBOT literature is available on-line, search "HBOT and radiation cystitis"

I have a stricture adjacent to the lower sphincter and for now I am treating it with 2x weekly self-catheterization to keep the stricture on hold.  Since HBOT, minor-moderate incontinence has resolved to none-minor and I do use women's extra light liners, or a heavier one when I'm on a 3 hours hike or going out for many hours.  The general concept for me is to heal the damaged tissue and then re-evaluate my LUTS. To gauge my symptom improvement: 2 years ago I peed slowly and leaked heavily doing situps and pullups in my daily gym-weight routine , and when hiking.. Now I might get a few drops. But then, it takes me a minute of sitting on the toilet to empty my bladder, not good. My PSA has been < .006 for a long time.

I may be a candidate for urethroplasty, I'm going to avoid AUS because it seems too dangerous given the existing stricture. 

[SimplyT in reply to awb1]

Thanks for the information. I finished 30 sessions of HBOT in August. It did help with the bleeding I was experiencing due to irradiation cystitis. I have to use a catheter almost daily now since I am experiencing blockage due to the blood or swelling from the catheter use. My cystitis came about 4 years after salvage radiation.

[Beatles64]

Had surgery to resolve urethral stricture (urethralplasty) prior to having my AUS implanted. You need a few months to recover before having the implant. Best decision I ever made. It takes 6 weeks to recover from swelling before device is activated. You should get an experienced doctor for the surgery.

[j-o-h-n in reply to Beatles64]

To the Beatles64,

(When I'm 64♬)........Would you be kind enough to let us know when and where you had the urethral stricture procedure performed? And your age then and now?. Thank you!!! Enjoy 2025.

Good Luck, Good Health and Good Humor.

j-o-h-n

[Beatles64 in reply to j-o-h-n]

Had my urethroplasty in 2016 at Sentara Norfolk General Hospital in Virginia. My doctor was part of Urology of Virginia practice ( Devine-Jordan Center For Reconstructive Surgery and Pelvic Health) in Virginia Beach. Phone: [phone]. I think my doctor has left the practice but they are well known for their excellent doctors. There are many experienced doctors in the U.S. that specialize in this type of surgery. Just do your research. My AUS was implanted by the same doctor at the end of 2016. I was 65 years old. Wish you the best!

[j-o-h-n in reply to Beatles64]

To Beatles64,

Thank you for your quick and detailed reply. You may want to copy and paste your post in your bio section. Stay well and stay happy. (geez I wish I was 64 y.o. again).

Good Luck, Good Health and Good Humor.

j-o-h-n

[SimplyT]

Thank you for your reply.