Transcorporal artificial urinary sphincter cuff placement is associated with a higher risk of postoperative urinary retention

Introduction: To explore the association of artificial urinary sphincter (AUS) cuff sizes and placement techniques with the development of postoperative urinary retention. Materials and methods: We analyzed the outcomes of AUS cases performed by a single surgeon at a tertiary referral center from 2007-2010. Outcomes relating to urinary retention and suprapubic tube placement were analyzed in three groups: those with 3.5 cm cuff placement, ≥ 4 cm cuff placement, and transcorporal cuff (TC) placement of any size. Results: Among 139 patients who underwent AUS placement from 2007-2010, 117 cases met inclusion criteria - 42 men received a 3.5 cm cuff, 53 received a ≥ 4 cm cuff, and 22 received a TC cuff (all ≥ 4 cm). TC patients had a significantly higher rate of urinary retention compared to the ≥ 4 cm group [7/22 (32%) versus 4/53 (8%), p = 0.02] as well as a higher rate of SPT placement [6/22 (27%) versus 1/53 (2%), p = 0.007]. Conclusions: Transcorporal cuff placement is associated with a significantly higher rate of urinary retention and suprapubic tube placement compared to traditional 4 cm cuff placement.