Department of Urology, University of Pittsburgh Medical Center, Pittsburgh, PA.
Department of Urology, University of Pittsburgh Medical Center, Pittsburgh, PA.
Urology. 2022 Nov;169:237-240. doi: 10.1016/j.urology.2022.06.032. Epub 2022 Jul 16.
To describe the novel gullwing technique for artificial urinary sphincter (AUS) placement. The transcorporal technique for AUS placement is beneficial in patients with 'fragile urethras' (previous failed AUS, urethroplasty or history of radiation) however limitations include insufficient lateral and ventral urethral support in addition to potential cinching during corporotomy closure which, in the absence of additional grafting may restrict our ability to conserve internal corporal capacity and limit options for future preservation of erectile function via penile prosthesis placement. The gullwing variation of the technique offers the potential to circumvent these disadvantages.
This case describes the gullwing variation of transcorporal AUS placement in a complex patient with a history of abdominopelvic trauma and prior failed AUS placements secondary to urethral erosion.
Transcorporal AUS placement in patients with prior urethral compromise has been shown to result in lower revision and erosion rates. The gullwing modification of the technique is a novel variation providing improved circumferential urethral protection and, with the addition of corporal grafting, aims to enable the preservation of the three-dimensional corporal volume necessary for ease of subsequent penile prosthesis implantation. However, studies assessing the long-term functional outcomes and durability of this technique are needed.
描述人工尿道括约肌（AUS）植入的新型翼状技术。对于“脆弱尿道”（先前的 AUS 失败、尿道成形术或放疗史）患者，经体腔 AUS 植入术具有优势，但其局限性包括侧向和腹侧尿道支撑不足，此外在体腔切开术关闭时存在潜在的收紧，这可能限制我们保留内部体腔容量的能力，并限制通过阴茎假体植入术保留勃起功能的未来选择。该技术的翼状变异具有规避这些缺点的潜力。
本病例描述了在一名复杂患者中经体腔翼状 AUS 植入的情况，该患者有腹部骨盆创伤史，先前因尿道侵蚀导致 AUS 植入失败。
先前有尿道损伤的患者进行经体腔 AUS 植入术可降低翻修率和侵蚀率。该技术的翼状改良是一种新颖的变异，可提供更好的环状尿道保护，并且通过添加体腔移植物，旨在保持后续阴茎假体植入术所需的三维体腔体积，便于植入。然而，需要评估该技术的长期功能结果和耐久性的研究。
