Literature DB >> 24958004

Long-term functional outcomes after artificial urinary sphincter implantation in men with stress urinary incontinence.

Priscilla Léon1, Emmanuel Chartier-Kastler1, Morgan Rouprêt1, Vanina Ambrogi2, Pierre Mozer1, Véronique Phé1.   

Abstract

OBJECTIVE: To evaluate long-term functional outcomes of artificial urinary sphincters (AUSs) and to determine how many men required explantation because of stress urinary incontinence (SUI) caused by sphincter deficiency after prostate surgery. PATIENTS AND METHODS: Men who had undergone placement of an AUS (American Medical Systems AMS 800®) between 1984 and 1992 to relieve SUI caused by sphincter deficiency after prostate surgery were included. Continence, defined as no need for pads, was assessed at the end of the follow-up. Kaplan-Meier survival curves estimated the survival rate of the device without needing explantation or revision.
RESULTS: In all, 57 consecutive patients were included with a median (interquartile range, IQR) age of 69 (64-72) years. The median (IQR) duration of follow-up was 15 (8.25-19.75) years. At the end of follow-up, 25 patients (43.8%) still had their primary AUS. The AUS was explanted in nine men because of erosion (seven) and infection (two). Survival rates, without AUS explantation, were 87%, 87%, 80%, and 80% at 5, 10, 15, and 20 years, respectively. Survival rates, without AUS revision, were 59%, 28%, 15%, and 5% at 5, 10, 15, and 20 years, respectively. At the end of the follow-up, in intention-to-treat analysis, 77.2% of patients were continent.
CONCLUSION: In the long term (>10 years) the AMS 800 can offer a high rate of continence to men with SUI caused by sphincter deficiency, with a tolerable rate of explantation and revision.
© 2014 The Authors. BJU International © 2014 BJU International.

Entities:  

Keywords:  outcomes; survival; urinary incontinence; urinary sphincter

Mesh:

Year:  2014        PMID: 24958004     DOI: 10.1111/bju.12848

Source DB:  PubMed          Journal:  BJU Int        ISSN: 1464-4096            Impact factor:   5.588


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