Rabinowitz, M, Liu, J, Haney, N, Du Comb, W, Burnett, A

Incontinence, Artificial urinary sphincter

This video describes our use of native periurethral tissue as a urethral bulking technique in patients with frail urethras during AUS surgery. An AUS is inserted or revised in the usual standard fashion. The state of the urethral tissue is inspected, and the circumference is measured. When the urethral circumference is less than 4 cm or the urethral tissue is frail, periurethral tissue bulking is performed. Dissection of the bulbospongiosus muscle is carried out at the level of the bulbar urethra, incorporating it with a circumferential measurement. In the event the bulbospongiosus muscle is inadequate for bulking, the proximal corpus spongiosum is mobilized distally as a ventral flap, beneath the circumferential measurement. The AUS size is then selected.

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