PURPOSE: To analyze revision rates and risk factors for artificial urinary sphincter failure. METHODS: Eighty-four patients underwent implantation of an artificial urinary sphincter in one reference center. Continence rates were defined by daily pad usage. Influence of predefined risk factors for device explantation, revision, differences in preoperative pad usage, and device survival was analyzed using Chi-squared test, Wilcoxon signed-rank test, and Kaplan-Meier analysis. A multivariate analysis was performed using a logistic regression model. A p value below 0.05 was considered statistically significant. RESULTS: After a mean follow-up of 39.7 months, the device was still in situ in 64 patients. In univariate analysis, perioperative need of anticoagulation led to a significant increase in urethral erosion (6 vs. 30 %; p = 0.002) and explantation rate (15 vs. 34 %; p = 0.047). Pelvic irradiation increased postoperative infection rates significantly (0 vs. 10 %; p = 0.018). Penoscrotal approach led to significant increase in urethral erosion rate (0 vs. 21 %; p = 0.015). Implantation of a double cuff led to a significant increase in explantation rate (58 vs. 24 %; p = 0.014), revision rate (75 vs. 38 %; p = 0.017), and infection rate (17 vs. 1 %; p = 0.008). When using cuff size of 3.5 cm, revision rate (20 vs. 50 %; p = 0.026) as well as incontinence rates (40 vs. 82 %; p = 0.014) was significantly lower. In multivariate analysis, only perioperative anticoagulation and double-cuff placement were independent predictors of artificial urinary sphincter failure. CONCLUSIONS: Our findings highlight the influence of perioperative anticoagulative therapy. In addition, the current study provides further evidence that double-cuff implantation should be performed only with caution during primary implantation.
PURPOSE: To analyze revision rates and risk factors for artificial urinary sphincter failure. METHODS: Eighty-four patients underwent implantation of an artificial urinary sphincter in one reference center. Continence rates were defined by daily pad usage. Influence of predefined risk factors for device explantation, revision, differences in preoperative pad usage, and device survival was analyzed using Chi-squared test, Wilcoxon signed-rank test, and Kaplan-Meier analysis. A multivariate analysis was performed using a logistic regression model. A p value below 0.05 was considered statistically significant. RESULTS: After a mean follow-up of 39.7 months, the device was still in situ in 64 patients. In univariate analysis, perioperative need of anticoagulation led to a significant increase in urethral erosion (6 vs. 30 %; p = 0.002) and explantation rate (15 vs. 34 %; p = 0.047). Pelvic irradiation increased postoperative infection rates significantly (0 vs. 10 %; p = 0.018). Penoscrotal approach led to significant increase in urethral erosion rate (0 vs. 21 %; p = 0.015). Implantation of a double cuff led to a significant increase in explantation rate (58 vs. 24 %; p = 0.014), revision rate (75 vs. 38 %; p = 0.017), and infection rate (17 vs. 1 %; p = 0.008). When using cuff size of 3.5 cm, revision rate (20 vs. 50 %; p = 0.026) as well as incontinence rates (40 vs. 82 %; p = 0.014) was significantly lower. In multivariate analysis, only perioperative anticoagulation and double-cuff placement were independent predictors of artificial urinary sphincter failure. CONCLUSIONS: Our findings highlight the influence of perioperative anticoagulative therapy. In addition, the current study provides further evidence that double-cuff implantation should be performed only with caution during primary implantation.
Authors: R Corey O'Connor; Dana K Nanigian; Bhavin N Patel; Michael L Guralnick; Lars M Ellision; Anthony R Stone Journal: Urology Date: 2007-01 Impact factor: 2.649
Authors: Ricarda M Bauer; Christian Gozzi; Wilhelm Hübner; Victor W Nitti; Giacomo Novara; Andrew Peterson; Jaspreet S Sandhu; Christian G Stief Journal: Eur Urol Date: 2011-03-21 Impact factor: 20.096
Authors: Gerard D Henry; Stephen M Graham; Robert J Cornell; Mario A Cleves; Caroline J Simmons; Ioannis Vakalopoulos; Brian Flynn Journal: J Urol Date: 2009-09-16 Impact factor: 7.450
Authors: Frank Van der Aa; Marcus J Drake; George R Kasyan; Andreas Petrolekas; Jean-Nicolas Cornu Journal: Eur Urol Date: 2012-11-23 Impact factor: 20.096
Authors: Alexander Kretschmer; Tanja Hüsch; Frauke Thomsen; Dominik Kronlachner; Tobias Pottek; Alice Obaje; Ralf Anding; Achim Rose; Roberto Olianas; Alexander Friedl; Wilhelm Hübner; Roland Homberg; Jesco Pfitzenmaier; Ulrich Grein; Fabian Queissert; Carsten M Naumann; Josef Schweiger; Carola Wotzka; Joanne N Nyarangi-Dix; Torben Hofmann; Alexander Buchner; Axel Haferkamp; Ricarda M Bauer Journal: World J Urol Date: 2016-02-25 Impact factor: 4.226
Authors: Roger K Khouri; Nicolas M Ortiz; Benjamin M Dropkin; Gregory A Joice; Adam S Baumgarten; Allen F Morey; Steven J Hudak Journal: Curr Urol Rep Date: 2021-03-29 Impact factor: 3.092
Authors: David Miller; Kelly Pekala; Xueying Zhang; Oluwaseun Orikogbo; Devin Rogers; Thomas W Fuller; Avinash Maganty; Paul Rusilko Journal: Cureus Date: 2022-05-31
Authors: M Grabbert; T Hüsch; A Kretschmer; R Kirschner-Hermanns; R Anding; A Rose; A Friedl; A Obaje; A Heidenreich; B Brehmer; C M Naumann; F Queissert; H Loertzer; J Pfitzenmaier; J Nyarangi-Dix; M Kurosch; R Olianas; R Homberg; R Abdunnur; J Schweiger; T Hofmann; C Wotzka; T Pottek; W Huebner; A Haferkamp; R M Bauer Journal: World J Urol Date: 2018-10-19 Impact factor: 4.226