Prospective follow-up study of artificial urinary sphincter placement preserving the bulbospongiosus muscle

2016 ◽  
Vol 36 (5) ◽  
pp. 1387-1394 ◽  
Author(s):  
Argimiro Collado Serra ◽  
José Domínguez-Escrig ◽  
Álvaro Gómez-Ferrer ◽  
Emilio Batista Miranda ◽  
José Rubio-Briones ◽  
...  
Keyword(s):  
Artificial Urinary Sphincter ◽  
Follow Up Study ◽  
Urinary Sphincter ◽  
Bulbospongiosus Muscle

scholarly journals Urinary Artificial Sphincter ZSI 375 for Treatment of Stress Urinary Incontinence in Men: 5 and 7 Years Follow-Up Report

2017 ◽  
Vol 84 (4) ◽  
pp. 263-266 ◽  
Author(s):  
Christophe Llorens ◽  
Tobias Pottek
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Artificial Urinary Sphincter ◽  
Minimal Period ◽  
Artificial Sphincter ◽  
Urethral Erosion ◽  
Randomised Study ◽  
Urinary Sphincter ◽  
Male Patients

Study Design This is a retrospective, non-randomised study. Objectives The aim of this study was to evaluate safety and efficacy of artificial urinary sphincter ZSI 375 inserted in male patients with stress urinary incontinence (SUI). Methods Between May 2009 and January 2017, 45 men with SUI underwent ZSI 375 device insertion. Operations were performed in two French centres by one surgeon. Complications and pad used to manage continence were recorded. Results From May 2009 to January 2012, 45 patients with a mean age of 70.42 years underwent placement of the ZSI 375 device in France. The most common cause for incontinence was radical prostatectomy (RP, 33/45 ­patients, 73.33%). The minimal period of incontinence was 6 months. Twenty-seven out of 45 patients (60.00%) had a severe incontinence (at least four pads per day), 13 patients (28.89%) had moderate incontinence (three pads per day) and five patients (11.11%) had two pads per day. With a long follow-up, the ZSI 375 device was considered to be successful in 73.33% patients after 5 years (60 months) and 72% of patients after 7 years (84 months). The infection rate was 2.2 % affecting one in 45 patients. Six out of 45 patients presented a urethral erosion (13.33%). Mechanical failure with a revision occurred in three patients (6.67%). Conclusions The ZSI 375 device is a safe and effective device to treat severe SUI in men.

scholarly journals Efficacy and safety of artificial urinary sphincter (AUS): Results of a large multi‐institutional cohort of patients with mid‐term follow‐up

2018 ◽  
Vol 38 (2) ◽  
pp. 710-718 ◽  
Author(s):  
Manuela Tutolo ◽  
Jean‐Nicolas Cornu ◽  
Ricarda M. Bauer ◽  
Sascha Ahyai ◽  
Giorgio Bozzini ◽  
...  
Keyword(s):  
Artificial Urinary Sphincter ◽  
Efficacy And Safety ◽  
Urinary Sphincter

scholarly journals Functional Outcomes and Long-term Durability of Artificial Urinary Sphincter Application: Review of 56 Patients With Long-term Follow-up

2013 ◽  
Vol 54 (6) ◽  
pp. 373 ◽  
Author(s):  
Ömer Gülpınar ◽  
Evren Süer ◽  
Mehmet İlker Gökce ◽  
Ahmet Hakan Haliloğlu ◽  
Erdem Öztürk ◽  
...  
Keyword(s):  
Functional Outcomes ◽  
Artificial Urinary Sphincter ◽  
Urinary Sphincter ◽  
Long Term Follow Up

Experience with artificial urinary sphincter implantation in men who underwent prior pelvic radiation therapy for prostate cancer.

2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 236-236
Author(s):  
Sameer G. Jhavar ◽  
Erin Bird ◽  
Gregory P. Swanson
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
Artificial Urinary Sphincter ◽  
Pelvic Radiation ◽  
Urinary Sphincter ◽  
Prior Surgery ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

236 Background: To assess outcomes after artificial urinary sphincter implantation in men who received prior pelvic radiation therapy. Methods: Between 1997 and 2012, 107 patients were identified from the Scott and White Hospital database who underwent artificial urinary sphincter implantation for urinary incontinence after prostate cancer treatment. Of these 17 were excluded for lack of follow-up data. Of the remaining 90 patients, 59 patients underwent prior surgery alone (group 1), 25 underwent prior surgery followed by pelvic radiation therapy (group 2); and 6 patients underwent prior radiation therapy alone. Results: Average ages at sphincter implantation were 69 yrs. (range 54 - 82), 73 yrs. (range 63 - 81), and 70 yrs. (range 60 - 80) respectively for groups 1, 2 and 3. Social continence rates were 80% (47/59) for group 1, 72% (18/25) for Group 2 and 50% (3/6) for group 3 at an average follow-up of 6 yrs. (range 0 - 17), 4 yrs. (range 1 - 12) and 3 yrs. (range 0 - 6) respectively. Average time between surgery and sphincter implantation was 5 yrs. (range 1-27) in group 1. Average time between radiation and sphincter implantation was 7 yrs. (range 1 - 18) and 6 yrs. (range 1 - 17) in Groups 2 and 3. Re-operation rates were 42% (25/59); 48% (12/25); and 50% (3/6) in groups 1, 2, and 3, respectively. In men who were incontinent at last follow-up, the average time between pelvic radiation and sphincter placement was relatively shorter as compared to those who were continent [5 yrs. (range 1 -11) vs. 7 yrs. (range 1 - 18) in Group 2; and 4 yrs. (range 1 -5) vs.10 yrs. (range 4 - 17) in group 3]. The rates of erosions were 10/59 (17%); 4/25 (16%); and 0/6 (0%) in groups 1, 2, and 3, respectively. The rates of infection were 5/59 (8%), 0/25 (0%), and 2/6 (33%) in groups 1, 2, and 3, respectively. Conclusions: Our experience with artificial urinary sphincter in men who underwent prior pelvic radiation therapy is comparable to that reported in the literature. Our results identify factors associated with worse continence after artificial urinary sphincter in men who underwent prior pelvic radiation therapy.

scholarly journals Prior Placement of Male Urethral Slings Can Increase the Need for Revision of Artificial Urinary Sphincters

2021 ◽  
Vol 10 (24) ◽  
pp. 5842
Author(s):  
Emily M. Yura ◽  
Christopher J. Staniorski ◽  
Jason E. Cohen ◽  
Liqi Chen ◽  
Ashima Singal ◽  
...  
Keyword(s):  
Retrospective Studies ◽  
Artificial Urinary Sphincter ◽  
Demographic Characteristics ◽  
Male Sling ◽  
Sling Procedure ◽  
Replacement Surgery ◽  
Academic Center ◽  
Urinary Sphincter ◽  
Significant Difference

Background: Recurrent stress urinary incontinence (SUI) following male sling can be managed surgically with artificial urinary sphincter (AUS) insertion. Prior small, single-center retrospective studies have not demonstrated an association between having failed a sling procedure and worse AUS outcomes. The aim of this study was to compare outcomes of primary AUS placement in men who had or had not undergone a previous sling procedure. Methods: A retrospective review of all AUS devices implanted at a single academic center during 2000–2018 was performed. After excluding secondary AUS placements, revision and explant procedures, 135 patients were included in this study, of which 19 (14.1%) patients had undergone prior sling procedures. Results: There was no significant difference in demographic characteristics between patients undergoing AUS placement with or without a prior sling procedure. Average follow up time was 28.0 months. Prior sling was associated with shorter overall device survival, with an increased likelihood of requiring revision or replacement of the device (OR 4.2 (1.3–13.2), p = 0.015) as well as reoperation for any reason (OR 3.5 (1.2–9.9), p = 0.019). While not statistically significant, patients with a prior sling were more likely to note persistent incontinence at most recent follow up (68.8% vs. 42.7%, p = 0.10). Conclusions: Having undergone a prior sling procedure is associated with shorter device survival and need for revision or replacement surgery. When considering patients for sling procedures, patients should be counseled regarding the potential for worse AUS outcomes should they require additional anti-incontinence procedures following a failed sling.

scholarly journals Stemming the tide of mild to moderate post-prostatectomy incontinence: A retrospective comparison of transobturator male slings and the artificial urinary sphincter

2014 ◽  
Vol 8 (7-8) ◽  
pp. 273 ◽  
Author(s):  
Nathan Y. Hoy ◽  
Keith F. Rourke
Keyword(s):  
Patient Satisfaction ◽  
Artificial Urinary Sphincter ◽  
Complication Rates ◽  
Retrospective Comparison ◽  
Urinary Sphincter ◽  
Significant Difference ◽  
Comorbidity Scores ◽  
Clavien Grade ◽  
Grade 3

Introduction: The AUS remains the gold standard treatment for post-prostatectomy incontinence (PPI), although most patients with mild-moderate PPI prefer a sling without strong evidence of procedural equivalence. This study compares outcomes of 2 procedures for the treatment of mild-moderate PPI.Methods: A retrospective review of 124 patients (76 transobturator sling, 48 AUS) with mild-moderate PPI requiring intervention over an 8-year period. The primary outcome was continence. Secondary outcomes included global patient satisfaction, improvement, and complication rates. Mild to moderate incontinence was defined as requiring ≤5 pads/day.Results: There was no significant difference in age (66.2 vs. 68.1 years; p = 0.17) or prostate cancer characteristics for slings and AUS, respectively. AUS patients had higher Charlson comorbidity scores and were more likely to have previous radiotherapy. Median length of follow up was 24 months for slings and 42 months for AUS. There was no difference in continence rates, 88.2% vs. 87.5% (p = 0.79), rate of improvement, 94.7% vs. 95.8% (p = 1.00), or patient satisfaction, 93.4% vs. 91.7% (p = 0.73), for slings and AUS, respectively. Complication rates were equivalent (19.7% vs.16.7%; p = 1.00), though a significantly higher proportion of complications with AUS were Clavien Grade 3 (0% vs. 75%; p = 0.006).Conclusions: For mild to moderate PPI there is no difference incontinence, satisfaction, or improvement rates, between AUS and slings. AUS complications tend to be more severe. Our study supports the use of slings as first-line treatment for mild-moderate PPI.

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