Fabian Queissert1, Tanja Hüsch2, Alexander Kretschmer3, Ralf Anding4, Ruth Kirschner-Hermanns4, Tobias Pottek5, Roberto Olianas6, Alexander Friedl7, Roland Homberg8, Jesco Pfitzenmaier9, Carsten M Naumann10, Joanne Nyarangi-Dix11, Torben Hofmann12, Achim Rose13, Josef Schweiger14, Wilhelm Hübner15, Hagen Loertzer16, Ricarda M Bauer3, Axel Haferkamp2, Andres J Schrader1. 1. Department of Urology and Pediatric Urology, University Hospital Munster, Munster, Germany. 2. Department of Urology and Pediatric Urology, University Medical Center of Johannes Gutenberg University, Mainz, Germany. 3. Department of Urology, Ludwig-Maximilians University, Munich, Germany. 4. Department of Urology, Pediatric Urology and Neuro-Urology, University Hospital Bonn, Bonn, Germany. 5. Department of Urology, Vivantes Hospital Am Urban, Berlin, Germany. 6. Department of Urology, Hospital Lueneburg, Lueneburg, Germany. 7. Department of Urology, Goettlicher Heiland Vienna, Vienna, Austria. 8. Department of Urology and Pediatric Urology, St. Barbara Hospital Hamm, Hamm, Germany. 9. Department of Urology, Evangelic Hospital Bethel, Bielefeld, Germany. 10. Department of Urology and Pediatric Urology, St. Elisabeth Hospital, Neuwied, Germany. 11. Department of Urology and Pediatric Urology, University Hospital Heidelberg, Heidelberg, Germany. 12. Department of Urology, Diakonie Hospital Schwaebisch Hall, Schwaebisch Hall, Germany. 13. Department of Urology and Pediatric Urology, Helios Hospital Duisburg, Duisburg, Germany. 14. Department of Urology and Pediatric Urology, Catholic Hospital St. Johann Nepomuk, Erfurt, Germany. 15. Department of Urology, Hospital Weinviertel Korneuburg, Korneuburg, Austria. 16. Department of Urology and Pediatric Urology, Westpfalz Medical Center, Kaiserslautern, Germany.
Abstract
AIM: To analyze the influence of implantation volume of artificial sphincters (AMS 800) on outcome in a large central European multicenter cohort study. METHODS: As part of the DOMINO (Debates on Male Incontinence) project, the surgical procedures and outcomes were retrospectively analyzed in a total of 473 patients who received an artificial sphincter (AMS 800) between 2010 and 2012. Clinics that implanted at least 10 AMS 800 per year were defined as high-volume centers. RESULTS: Sixteen centers had a mean rate of 9.54 AMS 800/y of which five clinics were identified as high-volume centers. They implanted significantly more double cuffs (55% vs 12.1%; P < .001), used the perineal approach significantly more often (78% vs 67.7%; P = .003) and chose larger mean cuff sizes (4.63 cm vs 4.42 cm; P = .002). With a mean follow-up of 18 months, the revision rate was significantly higher at low-volume centers (38.5% vs 26.7%; P = .037), urethral erosion being the main reason for revision. Social continence (0-1 pads/24 h) was achieved significantly more often in high-volume centers (45.5% vs 24.2%; P = .002). CONCLUSIONS: Our study showed significantly better continence results and lower revision rates at high-volume centers, confirming earlier results that are still true in this decade. We, therefore, recommend surgery for male incontinence at qualified centers.
AIM: To analyze the influence of implantation volume of artificial sphincters (AMS 800) on outcome in a large central European multicenter cohort study. METHODS: As part of the DOMINO (Debates on Male Incontinence) project, the surgical procedures and outcomes were retrospectively analyzed in a total of 473 patients who received an artificial sphincter (AMS 800) between 2010 and 2012. Clinics that implanted at least 10 AMS 800 per year were defined as high-volume centers. RESULTS: Sixteen centers had a mean rate of 9.54 AMS 800/y of which five clinics were identified as high-volume centers. They implanted significantly more double cuffs (55% vs 12.1%; P < .001), used the perineal approach significantly more often (78% vs 67.7%; P = .003) and chose larger mean cuff sizes (4.63 cm vs 4.42 cm; P = .002). With a mean follow-up of 18 months, the revision rate was significantly higher at low-volume centers (38.5% vs 26.7%; P = .037), urethral erosion being the main reason for revision. Social continence (0-1 pads/24 h) was achieved significantly more often in high-volume centers (45.5% vs 24.2%; P = .002). CONCLUSIONS: Our study showed significantly better continence results and lower revision rates at high-volume centers, confirming earlier results that are still true in this decade. We, therefore, recommend surgery for male incontinence at qualified centers.
Authors: Cristina Esquinas; Sonia Ruiz; Elena de Sancha; Mónica Vazquez; Juan F Dorado; Miguel Virseda; Ignacio Arance; Javier C Angulo Journal: Adv Ther Date: 2020-11-23 Impact factor: 3.845
Authors: Fabian Queissert; Keith Rourke; Sandra Schönburg; Alessandro Giammò; Andreas Gonsior; Carmen González-Enguita; Antonio Romero; Andres J Schrader; Francisco Cruz; Francisco E Martins; Juan F Dorado; Javier C Angulo Journal: J Clin Med Date: 2021-12-24 Impact factor: 4.241