The following is a summary of “Indications and Outcomes for Intermittent Catheterization following Bulbar AUS Cuff Placement,” published in the JANUARY 2023 issue of Urology by Krughoff, et al.

For a retrospective study, researchers sought to evaluate the functional and surgical impact of CIC protocols in men with a bulbar artificial urinary sphincter (AUS) in place to manage stress urinary incontinence (SUI) following prostate cancer treatment. The safety and feasibility of intermittent catheterization (CIC) in men with a bulbar AUS at the urethra had not been extensively studied, and there was sparse data to guide concomitant management of SUI and poor bladder emptying.

The study reviewed all bulbar urethral AUS procedures performed at the institution and included patients with a history of prostate cancer treatment, AUS placement for SUI, and a history of CIC before and/or after AUS placement. A total of 57 patients were identified under the care of two surgeons. Of these, 18 continued to perform CIC or first initiated CIC after AUS placement, and 39 discontinued CIC before AUS placement. The incidence of erosion and future AUS removal or replacement was compared between the two groups, and surgical and continence outcomes were analyzed.

A total of 57 individuals with a history of CIC and AUS placement under the supervision of two surgeons were found. After the placement of an AUS, 18 people continued to perform CIC or began CIC, while 39 people stopped performing CIC. After the insertion of an AUS, patients who maintained or stopped using CIC saw the same rate of erosion (17.9% vs. 22.2%, P =.79). Future AUS removal or replacement rates were the same (56.4% vs. 44.4%, P =.41). With the insertion of an AUS, urine incontinence improved in both groups.

The study concluded that bulbar AUS placement in continuous, intermittent catheterization could be considered in patients not surgical candidates for definitive treatment of their outlet obstruction. The results suggested that CIC can be safely performed in patients with a bulbar AUS and may improve outcomes in those with SUI following prostate cancer treatment.

Reference: goldjournal.net/article/S0090-4295(22)00899-8/fulltext