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Risk factors for resurgery in men with artificial urinary sphincter: R ole of urethral strictures
Author(s) -
Traverso Paolo,
Mantica Guglielmo,
Gallo Fabio,
Benelli Andrea,
Becco Davide,
De Rose Aldo Franco,
Simonato Alchiede
Publication year - 2019
Publication title -
luts: lower urinary tract symptoms
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.451
H-Index - 15
eISSN - 1757-5672
pISSN - 1757-5664
DOI - 10.1111/luts.12205
Subject(s) - medicine , contraindication , artificial urinary sphincter , hazard ratio , confidence interval , surgery , proportional hazards model , cuff , univariate analysis , stenosis , relative risk , urology , urinary incontinence , urethral sphincter , lower risk , multivariate analysis , alternative medicine , pathology
Objective The aims of the present study were to evaluate the outcome of implantation of an a rtificial u rinary s phincter ( AUS ) in male patients with iatrogenic urinary incontinence and to analyse possible risk factors for resurgery, with particular focus on the effects of posterior urethral strictures ( US ). Methods The outcomes of AUS implantation surgeries performed by 2 surgeons on consecutive patients between January 1999 and 2015 were evaluated retrospectively. Univariate analysis with C ox proportional hazard regression was used to assess correlations between resurgery (explantation or substitution of the urethral cuff) and risk factors. Hazard ratios (HR) associated with AUS survival and 95% confidence intervals (CI) were calculated and K aplan– M eier were constructed. Patients who underwent resurgery for mechanical failure were excluded from the study. Results In all, 73 male patients were monitored for a maximum of 190 months (median follow‐up duration 36 months). The risk of resurgery was 3.75‐fold greater in patients with than without stenosis ( HR 3.75; 95% CI 1.47‐9.59). In addition, K aplan– M eier survival curves showed a significantly shorter AUS survival time in patients with than without stenosis treatment. Conclusions Prior treatment for US increases the relative risk of AUS failure. Despite not being an absolute contraindication for AUS implantation, we suggest that patients with previous treatment for US are informed of potential risks.