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Long‐term functional outcomes after artificial urinary sphincter implantation in men with stress urinary incontinence
Author(s) -
Léon Priscilla,
ChartierKastler Emmanuel,
Rouprêt Morgan,
Ambrogi Vanina,
Mozer Pierre,
Phé Véronique
Publication year - 2015
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.12848
Subject(s) - artificial urinary sphincter , urinary incontinence , urology , medicine , urinary system , term (time) , sphincter , surgery , physics , quantum mechanics
Objective To evaluate long‐term functional outcomes of artificial urinary sphincters ( AUSs ) and to determine how many men required explantation because of stress urinary incontinence ( SUI ) caused by sphincter deficiency after prostate surgery. Patients and Methods Men who had undergone placement of an AUS ( A merican M edical S ystems AMS 800®) between 1984 and 1992 to relieve SUI caused by sphincter deficiency after prostate surgery were included. Continence, defined as no need for pads, was assessed at the end of the follow‐up. Kaplan– M eier survival curves estimated the survival rate of the device without needing explantation or revision. Results In all, 57 consecutive patients were included with a median (interquartile range, IQR ) age of 69 (64–72) years. The median ( IQR ) duration of follow‐up was 15 (8.25–19.75) years. At the end of follow‐up, 25 patients (43.8%) still had their primary AUS . The AUS was explanted in nine men because of erosion (seven) and infection (two). Survival rates, without AUS explantation, were 87%, 87%, 80%, and 80% at 5, 10, 15, and 20 years, respectively. Survival rates, without AUS revision, were 59%, 28%, 15%, and 5% at 5, 10, 15, and 20 years, respectively. At the end of the follow‐up, in intention‐to‐treat analysis, 77.2% of patients were continent. Conclusion In the long term (>10 years) the AMS 800 can offer a high rate of continence to men with SUI caused by sphincter deficiency, with a tolerable rate of explantation and revision.