Premium
Factors contributing to treatment outcomes of post‐prostatectomy incontinence surgery for the selection of the proper surgical procedure for individual patients: A single‐center experience
Author(s) -
Kim Myong,
Choi Daehun,
Hong Jun Hyuk,
Kim ChoungSoo,
Ahn Hanjong,
Choo MyungSoo
Publication year - 2018
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.23543
Subject(s) - medicine , urinary incontinence , prostatectomy , surgery , univariate analysis , nocturia , sling (weapon) , sphincter , single center , urology , urinary system , multivariate analysis , prostate cancer , cancer
Objectives To investigate the clinical and urodynamic parameters affecting the treatment outcomes of post‐prostatectomy incontinence (PPI) surgery. Patients and Methods We reviewed the patients with PPI who received an artificial urinary sphincter (AUS) or adjustable male sling (MS) from 2001 to 2016. Results A total of 103 patients (AUS, 53; adjustable MS, 50) with a mean age of 69.9 (±5.6, standard deviation) years were analyzed. The mean number of pads used daily was 4.8 (±3.4). The mean symptom duration and follow‐up duration were 46.9 (±31.1) and 31.0 (±21.4) months, respectively. The overall rate of treatment success (≤1 pad per day at last follow‐up) at 12 months postoperatively was 81.6%. Based on univariate analysis, previous pelvic irradiation ( P = 0.013), prior PPI surgery ( P = 0.017), and degree of incontinence ( P = 0.010) were inversely associated with the success of PPI surgery. In patients who received AUS, history of neurologic disease ( P = 0.038) was inversely associated with treatment success. However, in patients with an adjustable MS, previous pelvic irradiation ( P = 0.001), prior PPI surgery ( P = 0.022), and degree of incontinence ( P = 0.008) were inversely associated with treatment success. Conclusions Adjustable MS should be avoided in patients with previous pelvic irradiation, prior PPI surgery, or severe symptoms. Physicians should be aware that the treatment outcome of AUS might be compromised in patients with neurologic disease.