A case of artificial urinary sphincter implantation in a patient who underwent both urethroplasty and ileal neobladder construction.

BACKGROUND

AUS implantation is the standard treatment recommended by the European Urological Association and American Urological Association guidelines to treat stress urinary incontinence due to intrinsic sphincter deficiency. AUS implantation following a neobladder construction or urethroplasty has been previously reported; however, there are only a few reports on patients who have undergone both procedures.This report presents a unique case of a patient who underwent artificial urinary sphincter (AUS) implantation after undergoing both urethroplasty and ileal neobladder construction. CASE PRESENTATION: A 76-year-old male with a history of urethral stricture and ileal neobladder construction was referred to our department because of persistent stress urinary incontinence. A pressure-regulating balloon was placed in the left lower abdomen, where the peritoneum remained intact. The AUS was activated and urinary continence was restored approximately seven weeks post-surgery. In addition to standard usage instructions, the patient was advised on timed voiding and deactivation during the night and in the event of fever. Urinary incontinence significantly improved, and the effectiveness was maintained without complications one year post-surgery. Device infection and urethral erosion are critical complications that should be considered during AUS implantation. We focused on the site of AUS implantation and perioperative infection control to solve this problem.

CONCLUSION

AUS implantation was performed in the patient who underwent both urethroplasty and ileal neobladder construction. We felt that meticulous measures during and after the perioperative period are necessary to prevent urethral erosion and device infection.