[Effect and safety of device-preserving revision surgery in patients with device erosion following artificial urinary sphincter and sacral neuromodulation implantation].

Seven patients with lower urinary tract dysfunction who developed skin erosion after implant surgery at Beijing Hospital between June 2022 and November 2025 were prospectively studied. Follow-up was conducted at 1 month postoperatively (outpatient visit), and at 3, 6, and 12 months, and annually thereafter via telephone interviews, to assess wound healing, device function (where applicable), and complications. The age was (50.6±25.2) years. Time since implantation [M (Q1,Q3)] was 15 (12, 36) months, with erosion duration of 0.50 (0.17, 1.00) months. All patients were Clavien-Dindo grade Ⅲ. Three had artificial urethral sphincter (AUS) erosion: 2 with control pump extrusion underwent device-preserving debridement and revision; 1 developed urethral injury, scrotoperineal abscess, and systemic infection from catheterization with the AUS activated, requiring device removal, partial urethrectomy, and end-to-end anastomosis. Four had sacral neuromodulation (SNM) erosion: three with surgical-site breakdown and pulse generator exposure underwent device-preserving revision; 1 with fluctuance, tenderness, and purulent discharge required SNM explantation. Median follow-up was 14 (1, 23) months. Both AUS-preserved patients recovered uneventfully, with device reactivation at 6 weeks and social continence at last follow-up; the AUS-removed patient returned to pre-implant incontinence levels. All 3 SNM-preserved patients healed well with normal device function; the SNM-explanted patient returned to pre-SNM symptom levels. No surgery-related complications occurred by December 2025. Device-preserving revision is feasible for implant erosion without abscess or systemic infection and with adequate subcutaneous fat, provided risks are thoroughly discussed and informed consent is obtained.