Single incision artificial urethral sphincter

Abstract

We demonstrate a technique for artificial urinary sphincter placement using a single perineal incision. This incision allows for good exposure of the urethra, allowing for more proximal placement as needed. Perineal dissection and exposure are done in the usual manner for a perineal AUS. Once the cuff is in place, we dissect through the inguinal ring on either side. The reservoir is placed submuscularly, similar to the placement of an IPP reservoir. A finger is then used to displace the scrotum lateral to the testicle and spermatic cord. The pump is passed into this space. The skin of the scrotum over it is then bluntly dissected back to expose the dartos fascia overlying the pump. The overlying dartos is incised, and the pump is passed through it. The pump is then contained in the space between the skin and dartos, ensuring that it will not slip back out. The incision is then closed. This technique has reduced operative time compared to a normal perineal AUS.

Keywords

• AUS
• Single incision