C Guillot-Tantay1, E Chartier-Kastler2, P Mozer2, M-O Bitker2, F Richard2, V Ambrogi2, P Denys3, P Léon2, V Phé2. 1. Service d'urologie et de transplantation rénale, hôpital universitaire La Pitié Salpêtrière, Assistance publique-Hôpitaux de Paris, faculté de médecine Pierre et Marie Curie, Sorbonne universités, université Paris 6, 47-83, boulevard de L'hôpital, 75013 Paris, France. Electronic address: c.guillot.tantay@gmail.com. 2. Service d'urologie et de transplantation rénale, hôpital universitaire La Pitié Salpêtrière, Assistance publique-Hôpitaux de Paris, faculté de médecine Pierre et Marie Curie, Sorbonne universités, université Paris 6, 47-83, boulevard de L'hôpital, 75013 Paris, France. 3. Service de médecine physique et réadaptation, hôpital Raymond-Poincaré, Assistance publique-Hôpitaux de Paris, UFR des sciences de la santé Simone Veil, université Versailles-Saint-Quentin-en-Yvelines, 104, boulevard Raymond-Poincaré, 92380 Garches, France.
Abstract
OBJECTIVE: The aim of the study was to report the very long-term functional outcomes of artificial urinary sphincter (AUS) in male neurological patients. MATERIAL AND METHODS: Male neurological patients diagnosed with stress urinary incontinence due to sphincter deficiency and undergoing AUS (AMS 800®) implantation between 1985 and 1992 were enrolled. Continence, defined by no pad/condom usage, explantation and revision rates were reported. RESULTS: Fourteen patients with a median age of 27.3 years (IQR: 27.3-40.8) were included: four had a spinal cord injury and ten a spina bifida. Prior continence surgery was reported by 6 patients (42.9 %). Artificial urinary sphincter was implanted in a peribulbar (n=4) or periprostatic position (n=10). Median follow-up was 18.3 years (IQR: 10.1-20.3). At last follow-up, all patients were alive. Three native devices were still in place, eight were revised (four of them were secondarily explanted) and three were explanted due to erosion or infection. The 5-, 10-, 15-, 20-year explantation-free survival rates were respectively 85.7, 62.3, 52.0, 39.0 %. The 5-, 10-, 15-, 20-year revision-free survival rates were respectively 78.6, 42.9, 28.6, 7.1 %. At last follow-up, 50 % patients were continent. CONCLUSION: In the very long run, AUS provided a 50 % continence rate in male neurological patients but the revision rates were important. LEVEL OF EVIDENCE: 4.
OBJECTIVE: The aim of the study was to report the very long-term functional outcomes of artificial urinary sphincter (AUS) in male neurological patients. MATERIAL AND METHODS: Male neurological patients diagnosed with stress urinary incontinence due to sphincter deficiency and undergoing AUS (AMS 800®) implantation between 1985 and 1992 were enrolled. Continence, defined by no pad/condom usage, explantation and revision rates were reported. RESULTS: Fourteen patients with a median age of 27.3 years (IQR: 27.3-40.8) were included: four had a spinal cord injury and ten a spina bifida. Prior continence surgery was reported by 6 patients (42.9 %). Artificial urinary sphincter was implanted in a peribulbar (n=4) or periprostatic position (n=10). Median follow-up was 18.3 years (IQR: 10.1-20.3). At last follow-up, all patients were alive. Three native devices were still in place, eight were revised (four of them were secondarily explanted) and three were explanted due to erosion or infection. The 5-, 10-, 15-, 20-year explantation-free survival rates were respectively 85.7, 62.3, 52.0, 39.0 %. The 5-, 10-, 15-, 20-year revision-free survival rates were respectively 78.6, 42.9, 28.6, 7.1 %. At last follow-up, 50 % patients were continent. CONCLUSION: In the very long run, AUS provided a 50 % continence rate in male neurological patients but the revision rates were important. LEVEL OF EVIDENCE: 4.
Authors: Peter Rehder; Jannik Stuehmeier; Lukas Andrius Jelisejevas; Alexandra Gulacsi; Wolgang Horninger; Marco Pedrini Journal: Urol Case Rep Date: 2020-05-06
Authors: José Carlos Truzzi; Fernando Gonçalves de Almeida; Carlos Alberto Sacomani; Joceara Reis; Flávio Eduardo Trigo Rocha Journal: Int Braz J Urol Date: 2022 Mar-Apr Impact factor: 1.541