In situ urethroplasty at the time of artificial urinary sphincter explantation for urethral erosion: an 18-year single-center experience.

PURPOSE: We evaluated the outcomes of immediate in situ urethroplasty performed at the time of artificial urinary sphincter explantation for urethral erosion and explored the factors associated with postoperative wound dehiscence.

MATERIALS AND

METHODS

We retrospectively reviewed patients who underwent artificial urinary sphincter explantation for endoscopically confirmed urethral cuff erosion at a single tertiary referral center between January 2008 and September 2025. Partial erosions were managed using primary repair, whereas circumferential defects were treated using excision and primary anastomosis. The primary outcome was the postoperative urethral stricture-free rate. Secondary outcomes included postoperative wound dehiscence and secondary artificial urinary sphincter implantation. Exploratory subgroup analyses were performed to compare the patients with and without postoperative wound dehiscence.

RESULTS

Sixteen patients were included in the study. The median patient age was 76 years, and the median follow-up duration was 14 months. Six patients (37.5%) had prior pelvic radiation therapy and seven (43.8%) had diabetes mellitus. Postoperative urethral stricture occurred in one patient (6.3%), yielding a stricture-free rate of 93.8%. Postoperative wound dehiscence occurred in seven patients (43.8%). All wounds were limited to the subcutaneous tissue and were managed with secondary closure under local anesthesia (Clavien-Dindo grade IIIa). Secondary artificial urinary sphincter implantation was performed in seven patients (43.8%), with two patients requiring repeat explantation due to recurrent infection.

CONCLUSIONS

Immediate in situ urethroplasty at the time of artificial urinary sphincter explantation was associated with a low observed urethral stricture rate in this selected cohort, although interpretation is limited by the small sample size and absence of a comparator group.