Case Report of a Complex Colovesical Fistula Associated With an Infected Artificial Urinary Sphincter: Radiological and Clinical Manifestations and Treatment Discussion.

Surgical placement of an artificial urinary sphincter (AUS) is considered the gold standard treatment for stress urinary incontinence. However, this surgery is not without complications such as infection or AUS cuff erosion. In this case report, we describe delayed AUS cuff infection/cuff erosion (seven months post-placement) concomitantly seen in an 82-year-old man with colovesical and colocolonic fistulas. In the past, this patient with severe post-prostatectomy mixed urinary incontinence had undergone multiple previous continence operations, including prior repeated AUS placement, Bulkamid injection (Boston Scientific Corporation, Marlborough, MA), ProACT insertion (Uromedica, Inc., Plymouth, MN), and Botox bladder injection. This presentation led to a life-threatening infection and required immediate complex surgical intervention. We will discuss clinical and radiological diagnostic features and will highlight the potential risk factors for this delayed erosion.