Premium
Prospective follow‐up study of artificial urinary sphincter placement preserving the bulbospongiosus muscle
Author(s) -
Collado Serra Argimiro,
DomínguezEscrig José,
GómezFerrer Álvaro,
Batista Miranda Emilio,
RubioBriones José,
Solsorbón Eduardo
Publication year - 2017
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.23119
Subject(s) - medicine , urinary incontinence , artificial urinary sphincter , surgery , prospective cohort study , urinary retention , urinary system , urology , urethra
Aims Artificial urinary sphincter (AUS) AMS‐800® is an effective treatment for male stress urinary incontinence. The aim of the study was to assess the long‐term effectiveness and complications of artificial urinary sphincter placement preserving the bulbospongiosus muscle. Methods From April 2004 to March 2014, all consecutive male patients with urinary incontinence who underwent an AUS prosthesis insertion were prospectively evaluated. Surgical technique consisted of a perineal incision for cuff placement around the bulbous urethra preserving the bulbospongiosus muscle. Cure rate was defined as no pad use. Results A total of 82 consecutive patients (median age 68 years, range: 54‐78) were prospectively evaluated (median follow‐up 46 months, range: 12‐135). Bulbospongiosus muscles were preserved intact in all cases with no intraoperative complications. Postoperative complications were reported in 14 patients (1 urethral erosion). The overall cure rate (dry rate) was 76.8% and the median ICIQ‐UI score improved from 18 (range: 8‐21) to 4 (range: 0‐17) ( P < 0.001). Artificial urinary sphincter survival rate was 95.5% (95%CI 89.4‐100%) at 24 months and 62.6% (95%CI 45.5‐79.6%) at 60 months. The mechanical failure rate was 6.3% (median 46.1 months, range: 22.2‐100.9) and urethral atrophy and/or inadequate compression rate was 9.5% (median 58.6 months, range: 39‐101.4 months). Conclusions Our study suggests that placement of AUS preserving the bulbospongiosus muscle is technically easy and efficient, reports excellent continence rates and lower urethral erosion rates, and could delay the onset of urethral atrophy compared to other surgical procedures used for sphincter placement.