Anne Denormandie1, Emmanuel Chartier-Kastler2, Rebecca Haddad3, Gilberte Robain4, Cyrille Guillot-Tantay2, Véronique Phé2. 1. Department of Urology, AP-HP Sorbonne Université, La Pitié-Salpêtrière Academic Hospital, 47-83 boulevard de l'hôpital, 75651, Paris, France. acdenormandie@gmail.com. 2. Department of Urology, AP-HP Sorbonne Université, La Pitié-Salpêtrière Academic Hospital, 47-83 boulevard de l'hôpital, 75651, Paris, France. 3. AP-HP Sorbonne Université, GRC 001, GREEN Groupe de Recherche en Neuro-Urologie, Rothschild Hospital, Paris, France. 4. Department of Physical Medicine and Rehabilitation, AP-HP Sorbonne Université, Rothschild Hospital, Paris, France.
Abstract
PURPOSE: To assess the outcomes after artificial urinary sphincter (AUS) implantation in older women aged over 75 years. METHODS: A monocentric retrospective study included all non-neurological women aged over 75 years suffering from stress urinary incontinence (SUI) due to intrinsic sphincter deficiency and undergoing an AUS placement between 1991 and 2015. Early postoperative complications were reported according to Clavien-Dindo classification. Continence, defined as no pad use, was assessed at the end of follow-up. Explantation, revision and deactivation rates of the AUS were reported. A Kaplan-Meier survival curve was generated to evaluate the survival rate of the device without revision or explantation. RESULTS: Among 393 AUS implantations, a total of 45 patients, median age 77 years (IQR 75-79), were included. Twenty-six early postoperative complications occurred in 18 patients (40%) patients. All were minor Clavien grades (I-II) except one (grade IVa). Median follow-up was 36 months (IQR 16-96). Overall, 32 women (71.1%) still had their AUS in place at the end of the follow-up, without revision or explantation. The AUS was definitively removed in four (8.9%). The AUS required revisions in nine (20%) women. The 5- and 10-year survival rates of the device without revision or explantation were 78 and 50%, respectively. Three patients (6.7%) had their AUS deactivated. At last follow-up, in an intention-to-treat analysis, the continence rate was 68.9%. CONCLUSION: In women aged over 75-years-old, suffering from SUI, the AUS provides satisfactory functional results comparable to the general population.
PURPOSE: To assess the outcomes after artificial urinary sphincter (AUS) implantation in older women aged over 75 years. METHODS: A monocentric retrospective study included all non-neurological women aged over 75 years suffering from stress urinary incontinence (SUI) due to intrinsic sphincter deficiency and undergoing an AUS placement between 1991 and 2015. Early postoperative complications were reported according to Clavien-Dindo classification. Continence, defined as no pad use, was assessed at the end of follow-up. Explantation, revision and deactivation rates of the AUS were reported. A Kaplan-Meier survival curve was generated to evaluate the survival rate of the device without revision or explantation. RESULTS: Among 393 AUS implantations, a total of 45 patients, median age 77 years (IQR 75-79), were included. Twenty-six early postoperative complications occurred in 18 patients (40%) patients. All were minor Clavien grades (I-II) except one (grade IVa). Median follow-up was 36 months (IQR 16-96). Overall, 32 women (71.1%) still had their AUS in place at the end of the follow-up, without revision or explantation. The AUS was definitively removed in four (8.9%). The AUS required revisions in nine (20%) women. The 5- and 10-year survival rates of the device without revision or explantation were 78 and 50%, respectively. Three patients (6.7%) had their AUS deactivated. At last follow-up, in an intention-to-treat analysis, the continence rate was 68.9%. CONCLUSION: In women aged over 75-years-old, suffering from SUI, the AUS provides satisfactory functional results comparable to the general population.
Authors: Benoit Peyronnet; Eabhann O'Connor; Rose Khavari; Grégoire Capon; Andrea Manunta; Marta Allue; Juliette Hascoet; Victor W Nitti; Xavier Gamé; Jason Gilleran; Luis Castro-Sader; Jean-Nicolas Cornu; David Waltregny; Sascha Ahyai; Eric Chung; Daniel S Elliott; Georges Fournier; Benjamin M Brucker Journal: Neurourol Urodyn Date: 2018-10-09 Impact factor: 2.696