Rigi10™ Malleable Penile Prosthesis
Also Known As
Artificial Urinary Sphincter cuff erosion, AUS cuff erosion, urethral cuff erosion, device erosion (AUS), cuff perforation into urethra, sphincter cuff erosion.
Definition
Cuff erosion, in the context of urological prosthetic devices such as an Artificial Urinary Sphincter (AUS), refers to the gradual wearing away or migration of the device’s cuff component through the urethral tissue. This process can lead to the exposure of the cuff material into the urethral lumen or surrounding tissues.1 It is a significant complication that can compromise the function of the prosthetic device and may necessitate surgical intervention, including device removal and urethral repair.2 The erosion can occur due to various factors including pressure necrosis, infection, tissue atrophy, or improper surgical technique.1,2 The primary purpose of identifying and understanding cuff erosion is to facilitate timely diagnosis and management to prevent further complications such as urethral stricture, fistula formation, or persistent incontinence, and to preserve urethral integrity for potential future interventions.1,2
Clinical Context
Cuff erosion is a recognized complication primarily associated with the implantation of an Artificial Urinary Sphincter (AUS), a device commonly used to treat severe stress urinary incontinence, particularly in men following prostatectomy.1 It typically presents with symptoms such as scrotal inflammation (tenderness, erythema, swelling around the AUS pump, sometimes referred to as “pump-itis”), obstructive voiding symptoms, or worsening incontinence.1 These symptoms should prompt further investigation for cuff erosion.1 Patients with a history of pelvic radiation are at a higher risk of developing AUS cuff erosion.1 The diagnosis is often confirmed via cystoscopy, which can visualize the eroded cuff within the urethral lumen.2 Management of cuff erosion traditionally involves device removal and Foley catheter drainage, often followed by a period of urethral rest before considering further interventions like urethroplasty or AUS reimplantation.2 Early recognition and management are crucial to minimize complications such as urethral stricture, fistula, and to preserve options for future continence procedures.1,2