Performance of the artificial urinary sphincter implantation in men with urinary incontinence: Results from a contemporary long-term real-world nationwide analysis.
artificial urinary sphincter
extrusion
patients reported outcomes
urinary incontinence
Journal
Neurourology and urodynamics
ISSN: 1520-6777
Titre abrégé: Neurourol Urodyn
Pays: United States
ID NLM: 8303326
Informations de publication
Date de publication:
09 2022
09 2022
Historique:
revised:
26
04
2022
received:
08
03
2022
accepted:
10
05
2022
pubmed:
23
7
2022
medline:
26
8
2022
entrez:
22
7
2022
Statut:
ppublish
Résumé
The artificial urinary sphincter (AUS) is one of the most effective surgical treatments for male urinary incontinence regardless of its severity. Current knowledge comes from high-volume centers, but little is known about the performance of this surgery from community practices. This study aims to report contemporary AUS performance in a nationwide observational study in Colombia. Male patients who underwent AUS surgery with AMS 800™ between 2000 and 2020 in more than 17 centers and four cities were identified. Pre, intra, and postoperative characteristics were evaluated, mainly addressing patient reported outcomes measurements in the postoperative period. Retrospective and prospective data collection and descriptive analysis were completed. Kaplan-Meier analysis was used to determine AUS survival rate. Out of an initial 667 cases, a total of 215 patients met inclusion and exclusion criteria and were included. Mean age was 67 ± 9.4 years, and mean follow-up was 6.0 ± 4.4 years with maximum range of 14 years. The etiology of urinary incontinence was prostate cancer surgery in 141 (81%) of the cases. The rest of the cases were related to benign prostatic disease or spinal cord injury. It is noteworthy that out of 115 patients, only 59 (51.3%) reported previous formal pelvic floor rehabilitation. Subjective severity of urinary incontinence determined by a visual analog scale showed a decrease in 4.5 points after sphincter implantation. Sphincter removal was required in 50 (23.2%) cases. The main reasons for implant removal were urethral erosion and infection. The sphincter survival rate at 2, 5, 8, 10, and 14 years was 76%, 70%, 60%, 57%, and 17%, respectively. Of the subjects at the last follow-up with the device still in place, 80.7% defined their urinary condition as "does not cause or causes minor discomfort," and 99% would recommend the device to a friend or relative in the same condition. This series from a community-based practice shows the lack of adherence to clinical practice guidelines and the lack of standardized data collection. In contrast, this study provides real-world data on explantation and revision rates, allows physicians to inform patients and to have clear metrics for a shared decision-making process before the procedure.
Types de publication
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1573-1581Informations de copyright
© 2022 Wiley Periodicals LLC.
Références
Kim SP, Sarmast Z, Daignault S, Faerber GJ, McGuire EJ, Latini JM. Long-term durability and functional outcomes among patients with artificial urinary sphincters: a 10-Year retrospective review from the University of Michigan. J Urol. 2008;179(5):1912-1916. doi:10.1016/j.juro.2008.01.048
Sandhu JS, Breyer B, Comiter C, et al. Incontinence after prostate treatment: AUA/SUFU guideline. J Urol. 2019;202(2):369-378. doi:10.1097/JU.0000000000000314
Kretschmer A, Nitti V. Surgical treatment of male postprostatectomy incontinence: current concepts. Eur Urol Focus. 2017;3(4-5):364-376. doi:10.1016/j.euf.2017.11.007
MacDonald S, Colaco M, Terlecki R. Waves of change: national trends in surgical management of Male stress incontinence. Urology. 2017;108:175-179. doi:10.1016/j.urology.2017.04.055
Hussain M, Greenwell TJ, Venn SN, Mundy AR. The current role of the artificial urinary sphincter for the treatment of urinary incontinence. J Urol. 2005;174(2):418-424. doi:10.1097/01.ju.0000165345.11199.98
Myles PS, Myles DB, Galagher W, et al. Measuring acute postoperative pain using the visual analog scale: the minimal clinically important difference and patient acceptable symptom state. Br J Anaesth. 2017;118(3):424-429. doi:10.1093/bja/aew466
Klovning A. Validations of Research Methods for Urinary Incontinence in Women, 2010. https://www.med.uio.no/helsam/english/people/aca/atleklo/phd-atle-klovning2010.pdf
Scott FB, Bradley WETG. Treatment of urinary incontinence by an implantable prosthetic urinary sphincter. J Urol. 1974;112:75-80.
Thüroff JW, Abrams P, Andersson KE, et al. EAU guidelines on urinary incontinence. Eur Urol. 2011;59(3):387-400. doi:10.1016/j.eururo.2010.11.021
Gülpinar Ö, Süer E, Gökce MI, Haliloǧlu AH, Öztürk E, Arikan N. Functional outcomes and long-term durability of artificial urinary sphincter application: review of 56 patients with long-term follow-up. Korean J Urol. 2013;54(6):373-376. doi:10.4111/kju.2013.54.6.373
Sandhu JS, Maschino AC, Vickers AJ. The surgical learning curve for artificial urinary sphincter procedures compared to typical surgeon experience. Eur Urol. 2011;60(6):1285-1290. doi:10.1016/j.eururo.2011.05.048
Van Der Aa F, Drake MJ, Kasyan GR, Petrolekas A, Cornu JN. The artificial urinary sphincter after a quarter of a century: a critical systematic review of its use in male non-neurogenic incontinence. Eur Urol. 2013;63(4):681-689. doi:10.1016/j.eururo.2012.11.034
Dalkin BL, Wessells HCH. A national survey of urinary and health related quality of life outcomes in men with an artificial urinary sphincter for post-radical prostatectomy incontinence. J Urol. 2003;169(1):237-239.
Léon P, Chartier-Kastler E, Rouprêt M, Ambrogi V, Mozer P, Phé V. Long-term functional outcomes after artificial urinary sphincter implantation in men with stress urinary incontinence. BJU Int. 2015;115(6):951-957. doi:10.1111/bju.12848
Biardeau X, Aharony S, Campeau L, Corcos J, Artificial urinary sphincter: executive summary of the 2015 consensus conference. 2016;35(S2):S5-S7. https://doi.org/10.1002/nau.23001
Trigo Rocha F, Gomes CM, Mitre AI, Arap SSM. A prospective study evaluating the efficacy of the artificial sphincter AMS 800 for the treatment of postradical prostatectomy urinary incontinence and the correlation between preoperative urodynamic and surgical outcomes. Urology. 2008;71(1):85-89. doi:10.1016/j.urology.2007.09.009
O'Connor RC, Lyon MB, Guralnick MLBG. Long-term follow-up of single versus double cuff artificial urinary sphincter insertion for the treatment of severe postprostatectomy stress urinary in- continence. Urology. 2008;71:90-93.
Walsh IK, Williams SG, Mahendra V, Nambirajan TSA. Artificial urinary sphincter implantation in the irradiated patient: safety, efficacy and satisfaction. BJU Int. 2002;89:364-368.
Gousse AE, Madjar S, Lambert MMFI. Artificial urinary sphincter for post-radical prostatectomy urinary incontinence: long-term subjective results. J Urol. 2001;166:1755-1758.
Boswell TC, Elliott DS, Rangel LJ, Linder BJ. Long-term device survival and quality of life outcomes following artificial urinary sphincter placement. Transl Androl Urol. 2020;9(1):56-61. doi:10.21037/tau.2019.08.02
Yafi FA, DeLay KJ, Stewart C, Chiang J, Sangkum PHW. Device survival after primary implantation of an artificial urinary sphincter for male stress urinary incontinence. J Urol. 2017;197:759-765.
Queissert F, Huesch T, Kretschmer A, et al. Artificial urinary sphincter cuff size predicts outcome in male patients treated for stress incontinence: results of a large central European multicenter cohort study. Int Neurourol J. 2019;23(3):219-225. doi:10.5213/inj.1938032.016
Queissert F, Hüsch T, Kretschmer A, et al. High/low-volume center experience predicts outcome of AMS 800 in male stress incontinence: results of a large middle European multicenter case series. Neurourol Urodyn. 2020;39(6):1856-1861. doi:10.1002/nau.24444