Yasuhiro Kaiho1, Hitoshi Masuda2, Mineo Takei3, Takahiro Hirayama4, Takahiko Mitsui5, Minato Yokoyama2, Takeya Kitta5, Naoki Kawamorita6, Haruo Nakagawa6, Masatsugu Iwamura4, Yoichi Arai6. 1. Department of Urology, Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Urology, Tohoku Medical and Pharmaceutical University, Sendai, Japan. Electronic address: kaiho@uro.med.tohoku.ac.jp. 2. Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan. 3. Harasanshin Hospital, Fukuoka, Japan. 4. Department of Urology, Kitasato University School of Medicine, Sagamihara, Japan. 5. Department of Renal and Genitourinary Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan. 6. Department of Urology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Abstract
PURPOSE: We performed a multicenter, prospective, observational study to assess outcomes, including changes in continence status and quality of life, after artificial urinary sphincter implantation. MATERIALS AND METHODS: Prospectively enrolled in this study were 135 patients who underwent primary AMS 800™ implantation between 2011 and 2014 at 1 of 5 institutions. Perioperative complications were categorized according to the Clavien-Dindo classification. We estimated the revision-free rate, that is the incidence of patients who did not undergo artificial urinary sphincter revision surgery. Cox regression analysis was performed to identify patient risk factors for revision surgery. The number of pads needed per day, ICIQ-SF (International Consultation on Incontinence Questionnaire-Short Form) and KHQ (King's Health Questionnaire) were used to estimate continence status and quality of life preoperatively, and 1, 3 and 12 months postoperatively. RESULTS: The artificial urinary sphincter was implanted without major complications. The revision-free rate 1, 2 and 3 years after implantation was 94%, 88% and 81%, respectively. Diabetes mellitus and poor preoperative American Society of Anesthesiologists® physical status were significant risk factors for revision surgery. Continence status and quality of life were markedly improved after surgery. However, ICIQ-SF and some KHQ items showed slight but significant deterioration at 12 months compared with scores 1 month after surgery. CONCLUSIONS: Artificial urinary sphincter implantation is a safe and durable procedure that substantially improves patient continence status and quality of life soon after surgery. Our results indicate that patients start to experience slight but noticeable deterioration in continence status and quality of life relatively early (within 1 year) after surgery. This finding might be helpful with appropriately counseling patients who undergo artificial urinary sphincter implantation.
PURPOSE: We performed a multicenter, prospective, observational study to assess outcomes, including changes in continence status and quality of life, after artificial urinary sphincter implantation. MATERIALS AND METHODS: Prospectively enrolled in this study were 135 patients who underwent primary AMS 800™ implantation between 2011 and 2014 at 1 of 5 institutions. Perioperative complications were categorized according to the Clavien-Dindo classification. We estimated the revision-free rate, that is the incidence of patients who did not undergo artificial urinary sphincter revision surgery. Cox regression analysis was performed to identify patient risk factors for revision surgery. The number of pads needed per day, ICIQ-SF (International Consultation on Incontinence Questionnaire-Short Form) and KHQ (King's Health Questionnaire) were used to estimate continence status and quality of life preoperatively, and 1, 3 and 12 months postoperatively. RESULTS: The artificial urinary sphincter was implanted without major complications. The revision-free rate 1, 2 and 3 years after implantation was 94%, 88% and 81%, respectively. Diabetes mellitus and poor preoperative American Society of Anesthesiologists® physical status were significant risk factors for revision surgery. Continence status and quality of life were markedly improved after surgery. However, ICIQ-SF and some KHQ items showed slight but significant deterioration at 12 months compared with scores 1 month after surgery. CONCLUSIONS: Artificial urinary sphincter implantation is a safe and durable procedure that substantially improves patient continence status and quality of life soon after surgery. Our results indicate that patients start to experience slight but noticeable deterioration in continence status and quality of life relatively early (within 1 year) after surgery. This finding might be helpful with appropriately counseling patients who undergo artificial urinary sphincter implantation.
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: Yves Deruyver; Charlotte Schillebeeckx; Elodie Beels; Dirk De Ridder; Frank Van der Aa Journal: World J Urol Date: 2021-11-25 Impact factor: 4.226
Authors: Ireneusz Ostrowski; Emil Śledź; Jacek Wilamowski; Mateusz Józefczak; Wojciech Dyś; Janusz Ciechan; Tomasz Drewa; Piotr Ludwik Chłosta Journal: Cent European J Urol Date: 2020-06-19