Manuela Tutolo1,2, Jean-Nicolas Cornu3, Ricarda M Bauer4, Sascha Ahyai5,6, Giorgio Bozzini7, John Heesakkers8, Marcus J Drake9, Kari A O Tikkinen10, Ene Launonen11, Stéphane Larré12, Nikesh Thiruchelvam13, Richard Lee14, Philip Li14, Michele Favro15, Emanuele Zaffuto2, Alexander Bachmann16, Juan I Martinez-Salamanca17, Thomas Pichon18, Cosimo De Nunzio19, Enrico Ammirati20, Francois Haab21, Frank Van Der Aa1. 1. Department of Urology, University Hospitals Leuven, Leuven, Belgium. 2. Division of Oncology, Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy. 3. Department of Urology, CHU Charles Nicolle, Rouen, France. 4. Department of Urology, Ludwig-Maximilians-University, Munich, Germany. 5. Department of Urology, University-Medical-Center Hamburg, Hamburg, Germany. 6. Department of Urology, University Hospital Göttingen, Göttingen, Germany. 7. Department of Urology, Humanitas Mater Domini, Milan, Italy. 8. Department of Urology, Radboud University Nijmegen MC, Nijmegen, The Netherlands. 9. University of Bristol and Bristol Urological Institute, Bristol, United Kingdom. 10. Department of Urology and Public Health, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. 11. Department of Surgery, Hyvinkää Hospital, Hyvinkää, Finland. 12. Department of Urology, CHU De Reims, Reims, France. 13. Department of Urology, Cambridge University Hospitals Trust, Cambridge, United Kingdom. 14. Department of Urology, NewYork-Presbyterian/Weill Cornell Medical Center, New York, New York. 15. Department of Urology, Ospedale Maggiore Della Carità Di Novara, Novara, Italy. 16. Department of Urology, University Hospital of Basel, Basel, Switzerland. 17. Department of Urology, Hospital Universitario Puerta de Hierro-Majadahonda, Universidad Autónoma de Madrid, Madrid, Spain. 18. Department of Urology, Angers University Hospital, Angers, France. 19. Department of Urology, Azienda Ospedaliera Sant'Andrea, Rome, Italy. 20. Department of Urology, Azienda Ospedaliera Universitaria, Città Della Salute E Della Scienza, Ospedale Molinette, Turin, Italy. 21. Institution Tenon Hospital, Paris, France.
Abstract
AIMS: To assess efficacy and safety as well as predictive factors of dry rate and freedom from surgical revision in patients underwent AUS placement. The artificial urinary sphincter (AUS) is still considered the standard for the treatment of moderate to severe post-prostatectomy stress urinary incontinence (SUI). However, data reporting efficacy and safety from large series are lacking. METHODS: A multicenter, retrospective study was conducted in 16 centers in Europe and USA. Only primary cases of AUS implantation in non-neurogenic SUI after prostate surgery, with a follow-up of at least 1 year were included. Efficacy data (continence rate, based on pad usage) and safety data (revision rate in case of infection and erosion, as well as atrophy or mechanical failure) were collected. Multivariable analyses were performed in order to investigate possible predictors of the aforementioned outcomes. RESULTS: Eight hundred ninety-two men had primary AUS implantation. At 32 months mean follow-up overall dry rate and surgical revision were 58% and 30.7%, respectively. Logistic regression analysis showed that patients without previous incontinence surgery had a higher probability to be dry after AUS implantation (OR: 0.51, P = 0.03). Moreover institutional case-load was positively associated with dry rate (OR: 1.18; P = 0.005) and freedom from revision (OR: 1.51; P = 0.00). CONCLUSIONS: The results of this study showed that AUS is an effective option for the treatment of SUI after prostate surgery. Moreover previous incontinence surgery and low institutional case-load are negatively associated to efficacy and safety outcomes.
AIMS: To assess efficacy and safety as well as predictive factors of dry rate and freedom from surgical revision in patients underwent AUS placement. The artificial urinary sphincter (AUS) is still considered the standard for the treatment of moderate to severe post-prostatectomy stress urinary incontinence (SUI). However, data reporting efficacy and safety from large series are lacking. METHODS: A multicenter, retrospective study was conducted in 16 centers in Europe and USA. Only primary cases of AUS implantation in non-neurogenic SUI after prostate surgery, with a follow-up of at least 1 year were included. Efficacy data (continence rate, based on pad usage) and safety data (revision rate in case of infection and erosion, as well as atrophy or mechanical failure) were collected. Multivariable analyses were performed in order to investigate possible predictors of the aforementioned outcomes. RESULTS: Eight hundred ninety-two men had primary AUS implantation. At 32 months mean follow-up overall dry rate and surgical revision were 58% and 30.7%, respectively. Logistic regression analysis showed that patients without previous incontinence surgery had a higher probability to be dry after AUS implantation (OR: 0.51, P = 0.03). Moreover institutional case-load was positively associated with dry rate (OR: 1.18; P = 0.005) and freedom from revision (OR: 1.51; P = 0.00). CONCLUSIONS: The results of this study showed that AUS is an effective option for the treatment of SUI after prostate surgery. Moreover previous incontinence surgery and low institutional case-load are negatively associated to efficacy and safety outcomes.
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: Lynda Constable; Paul Abrams; David Cooper; Mary Kilonzo; Nikki Cotterill; Chris Harding; Marcus J Drake; Megan N Pardoe; Alison McDonald; Rebecca Smith; John Norrie; Kirsty McCormack; Craig Ramsay; Alan Uren; Tony Mundy; Cathryn Glazener; Graeme MacLennan Journal: Health Technol Assess Date: 2022-08 Impact factor: 4.106
Authors: Roger K Khouri; Yooni A Yi; Nicolas M Ortiz; Adam S Baumgarten; Ellen E Ward; Maia E VanDyke; Steven J Hudak; Allen F Morey Journal: Int Braz J Urol Date: 2021 Mar-Apr Impact factor: 1.541