Management of cuff erosion of the double cuff artificial urinary sphincter.

PURPOSE: We report on a series of patients with erosion of 1 cuff of an AMS800 double cuff artificial urinary sphincter and determine the success rate of removing the eroded cuff, leaving the other components behind and converting the device to a single cuff system. MATERIALS AND METHODS: In 9 patients with a double cuff artificial sphincter 1 eroded cuff was removed and the system was converted to a single cuff sphincter. RESULTS: Followup was based on an incontinence scoring system. In 1 patient the remaining cuff was removed because it also eroded. In another patient a wound infection developed 5 months after placement and the entire device was removed. The remaining 7 patients had better continence scores than before artificial sphincter placement but each remarked that continence was better with 2 cuffs. CONCLUSIONS: An eroded cuff of a double cuff artificial urinary sphincter system can be successfully removed and the device can be converted to a single cuff system.

Concordance of smooth pursuit and saccadic measures in normal monozygotic twin pairs.

Although the range of normal ocular motor performance is broad, little is known about the sources of variability. Genetic transmission of eye movement deficits has been described but such possible control of normal function has been little investigated. Characteristics of smooth pursuit and saccades can be examined for the degree of concordance in related individuals. In this pilot study, we studied saccades and pursuit in eight monozygotic (MZ) twin pairs. The statistical analysis of the data used the intraclass correlation of MZ twins (rMZ) to estimate what fraction the covariance of the twin pairs was of the population variance. All saccadic measures showed significant MZ correlations (p < 0.05). Smooth pursuit gains were even more highly correlated (p < 0.001). These results indicate considerable similarity within pairs of twins, particularly for horizontal smooth pursuit, and suggest that larger studies on monozygotic and dizygotic twins would be desirable, to help separate out the relative contributions of environmental and genetic factors.