Do the etiological factors in artificial urinary sphincter reimplantation cases affect success and complications?
Background/aim:
The artificial urinary sphincter (AUS) is still one of the best options for incontinence treatment. It may also have an
advantage for revision or reimplantation in the management of complications. In this study we aimed to discuss the etiological factors
for AUS reimplantation and effects of these etiological factors on success rates, patient satisfaction rates, time to reimplantation surgery,
and complications.
Materials and methods:
Data from 30 patients for whom AUS reimplantation was performed were analyzed retrospectively. Incontinence
due to fluid loss from the cuff or reservoir balloon, inability of the cuff to adequately compress the urethra, and devices that were thought
to have completed their lifespans were defined as mechanical reasons while incontinence caused by conditions such as cuff erosion and
infection were defined as nonmechanical reasons. Patients who went through reimplantation due to mechanical and nonmechanical
causes were included in Group 1 and Group 2, respectively. Success rates, patient satisfaction rates, time between the implantation of the
first and second AUS, and complications were compared between the groups.
Results:
The mean follow-up period was 79 (3-308) months for patients who went through primary AUS implantation due to
postprostatectomy incontinence. Our success rates were found as 75% and 66% in Group 1 and Group 2, respectively. The differences
between the groups in terms of success and patient satisfaction rates were not statistically significant, while the time to reimplantation
was longer in Group 1 and statistically significant.
Conclusion:
Reasons for AUS reimplantation may affect the success and patient satisfaction rates. Our success rates of AUS performed
for nonmechanical reasons were slightly lower, but not statistically significantly so. AUS reimplantation may take a longer time if
mechanical failure is detected.
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- Shamliyan TA, Wyman JF, Ping R, Wilt TJ, Kane RL. Male
urinary incontinence: prevalence, risk factors, and preventive
interventions. Rev Urol 2009; 11: 145-165.
- Thom D. Variation in estimates of urinary incontinence
prevalence in the community: effects of differences in
definition, population characteristics, and study type. J Am
Geriatr Soc 1998; 46: 473-480.
- Nitti VW
. The prevalence of urinary incontinence. Rev Urol
2001; 3: 2-6.
- Lucas MG, Bedretdinova D, Bosch JLHR, Burkhard F, Cruz F,
Nambiar AK, Nilsson CG, de Ridder DJMK, Tubaro A, Pickard
RS et al. Guidelines on Urinary Incontinence. European Society
for Urinary Incontinence. Arnhem, the Netherlands: European
Association of Urology; 2014.
- Porena M, Mearini E, Mearini L, Vianello A, Giannantoni A.
Voiding dysfunction after radical retropubic prostatectomy:
more than external urethral sphincter deficiency. Eur Urol
2007; 52: 38-45.
- Loughlin KR, Prasad MM. Post-prostatectomy urinary
incontinence: a confluence of 3 factors. J Urol 2010; 183: 871-
877.
- Kundu SD, Roehl KA, Eggener SE, Antenor JA, Han M,
Catalona WJ. Potency, continence and complications in 3,477
consecutive radical retropubic prostatectomies. J Urol 2004;
172: 2227-2231.
- Trigo Rocha F, Gomes CM, Mitre AL, Arap S, Srougi M.
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: 85-89.
- Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013. CA
Cancer J Clin 2013; 63: 11-30.
- Cooperberg MR, Broering JM, Litwin MS, Lubeck DP, Mehta
SS, Henning JM, Carroll PR. The contemporary management of
prostate cancer in the United States: lessons from the cancer of
the prostate strategic urologic research endeavor (CapSURE), a
national disease registry. J Urol 2004; 171: 1393-1401.
- Hu JC, Elkin EP, Pasta DJ, Lubeck DP, Kattan MW, Carroll PR,
Litwin MS. Predicting quality of life after radical prostatectomy:
results from CapSURE. J Urol 2004; 171: 703-708.
- Singla N, Singla AK. Post-prostatectomy incontinence:
etiology, evaluation, and management. Turkish Journal of
Urology 2014; 40: 1-8.
- 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 years
retrospective review from the University of Michigan. J Urol
2008; 179: 1912-1916.
- Venn SN, Greenwell TJ, Mundy AR. The long-term outcome of
artificial urinary sphincters. J Urol 2000; 164: 702-706.
- Hajivassiliou CA. A review of the complications and results of
implantation of the AMS artificial urinary sphincter. Eur Urol
1999; 35: 36-44.
- Clemens JQ, Schuster TG, Konnak JW, McGuire EJ, Faerber GJ.
Revision rate after artificial urinary sphincter implantation for
incontinence after radical prostatectomy: actuarial analysis. J
Urol 2001; 166: 1372-1375.
- James MH, McCammon KA. Artificial urinary sphincter for
post-prostatectomy incontinence: a review. Int J Urol 2014; 21:
536-543.
- Anusionwu II, Wright EJ. Indications for revision of artifıcial
urinary sphincter and modifiable risk factors for device-related
morbidity. Neurourol Urodyn 2013; 32: 63-65.
- Raj GV, Peterson AC, Toh KL, Webster GW. Outcomes
following revisions and secondary implantation of the artificial
urinary sphincter. J Urol 2005; 173: 1242-1245.
- Tuygun C, Imamoglu A, Gucuk A, Goktug G, Demirel F.
Comparison of outcomes for adjustable bulbourethral male
sling and artificial urinary sphincter after previous artificial
urinary sphincter erosion. Urology 2009; 73: 1363-1370.
- Shen YC, Chiang PH
.
The experience of artificial urinary
sphincter implantation by a single surgeon in 15 years.
Kaohsiung J Med Sci 2013; 29
:
157-160.
- Bugeja S, Ivaz SL, Frost A, Andrich DE, Mundy AR.
Urethral atrophy after implantation of an artificial urinary
sphincter: fact or fiction? BJU Int 2016; 117: 669-676.
- Wang R, McGuire EJ, He C, Faerber GJ, Latini JM. Long-term
outcomes after primary failures of artificial urinary sphincter
ımplantation. Urology 2012; 79: 922-928.
- Linder BJ, Cogain M, Elliott DS. Long-term device outcomes
of artificial urinary sphincter reimplantation following prior
explanation for erosion or ınfection. J Urol 2014; 191: 734-738.