Artificial Urinary Sphincter Cuff Management: Essentials for the General Urologist by Dr. Simhan скачать в хорошем качестве

Artificial Urinary Sphincter Cuff Management: Essentials for the General Urologist by Dr. Simhan

Jay Simhan, MD, FACS, Professor of Urology, Fox Chase Cancer Center, Philadelphia, Pennsylvania, explores the complexities of managing artificial urinary sphincters (AUS). In this 19-minute presentation, Dr. Simhan focuses on patients with prolonged catheterization, hematuria, and bladder tumors and shares cases and images to illustrate his viewpoints. Dr. Simhan highlights the increasing need for AUS management due to prostate cancer treatment, radiation, and aging-related complications. He emphasizes the high-risk nature of erosion, and how improper cuff sizing contributes to poor outcomes. He also shares data from leading institutions illustrating that prolonged catheterization significantly increases AUS failure rates, making careful preoperative planning essential. A detailed algorithm for managing AUS in patients requiring cystoscopic interventions distinguishes between flexible and rigid instrumentation, underscoring when unbuckling or removing the cuff is necessary. Insights from recent studies stress that lower-pressure regulating balloons reduce erosion risks, challenging past assumptions about smaller cuffs. Dr. Simhan provides practical recommendations for optimizing AUS management and prioritizing patient outcomes while minimizing irreversible complications.