A cost‐utility analysis of artificial urinary sphincter versus AdVance male sling in post prostatectomy stress urinary incontinence: A publicly funded health care perspective

Shamout, Samer; Nazha, Sara; Dragomir, Alice; Campeau, Lysanne

doi:10.1002/nau.23559

Cited by 8 publications

(2 citation statements)

References 23 publications

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“…AUS was extensively studied in the last 4 decades and was found to have durable long-term results with a continence rate of about of 80–90% on long-term follow up and reported patient satisfaction up to 90% ( 39 - 41 ). In addition, AUS has been found to be more cost-effective when compared with male urethral slings ( 42 ). It is considered the preferred surgical treatment option for men with moderate to severe SUI and in men with history of pelvic radiation therapy suffering from any degree of SUI ( 1 ).…”

Section: Managementmentioning

confidence: 99%

Treatment of male stress urinary incontinence at time of inflatable penile prosthesis placement a review of contemporary literature

Elbakry,

O’Connor,

Yafi

et al. 2024

Transl Androl Urol

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Background and Objective Male stress urinary incontinence (SUI) and erectile dysfunction (ED) are well established diagnoses within Men’s Health, often more specifically within the prostate cancer survivorship cohort. Taken individually, well defined treatment algorithms exist with which many surgeons are comfortable; however, treatment of both in a single setting or staged fashion introduces complexity. Emerging treatment options also exist, and there is immature or minimal data when these are combined with inflatable penile prosthesis (IPP) insertion, radiation history, and/or variable degrees of incontinence. Our objective was to describe and summarize the currently available treatment options for SUI particularly at the time of IPP insertion. Methods A literature review was performed to summarize contemporary treatment of SUI at time of IPP placement. Anecdotal experience was added from high volume, subspecialty trained Men’s Health and Reconstructive Urologists. Key Content and Findings Non-invasive approaches such as pelvic floor muscle training (PFMT), behavioral modification, and external compression devices play some limited role in treatment and/or management of SUI, particularly in the early post operative period, or for those unwilling or unable to undergo more definitive intervention. More invasive options such as artificial urinary sphincter (AUS) implantation, male sling, or other implantable devices are more appropriate for good surgical candidates with higher bother and/or more severe incontinence. These options can be concomitant or staged relative to IPP placement. Climacturia, particularly with mild or no bothersome SUI, can successfully be addressed at the time of penile prosthesis placement with the utilization of the Mini-Jupette suburethral sling. Conclusions A variety of treatment options exist for concomitant treatment of SUI at time of IPP, and both safety and efficacy have been demonstrated for many in the same operative setting. As with treatment of ED or SUI in isolation, patient selection, careful counseling, and management of expectations can lead to high patient satisfaction.

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Section: Managementmentioning

confidence: 99%

Treatment of male stress urinary incontinence at time of inflatable penile prosthesis placement a review of contemporary literature

Elbakry,

O’Connor,

Yafi

et al. 2024

Transl Androl Urol

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“…Moreover, the exact price of the AMS 800 device can vary among the AP countries depending on the local distributor price and payment by a third‐party insurer. In countries where various surgical continence devices are available, the AMS 800 device appears to offer a more cost‐effective solution than male sling 66 and collagen injection 67 for males with severe SUI, especially in the longer term.…”

Section: Main Recommendationsmentioning

confidence: 99%

The Asia‐Pacific AMS800 artificial urinary sphincter consensus statement

et al. 2022

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This Asia-Pacific (AP) AMS 800 TM artificial urinary sphincter (AUS) consensus statement aims to provide a set of practical recommendations to assist surgeons with the AMS 800 device surgery. The AP consensus committee consisted of key opinion leaders with extensive experience with AMS 800 surgery across several AP countries. The panel reviewed and discussed relevant findings with emphasis on locoregional and specific clinical challenges relevant to the AP region. Recommendations were made in key areas namely (1) patient selection and informed consent process; (2) preoperative assessment; (3) dealing with co-existing urological disorders; (4) surgical principles and intraoperative troubleshooting; (5) postoperative care; (6) special populations; and (7) cost analysis and comparative review. The AMS 800 device should be offered to males with moderate to severe stress urinary incontinence (SUI). Full informed consent should be undertaken, and emphasis is placed on surgical contraindications and high-risk candidates. The presence of a surgical mentor or referral to experts is recommended in complex AUS candidates. Preoperative cystoscopy with or without multichannel urodynamic study is necessary and patients with pre-existing urological disorders should be treated adequately and clinically stable before surgery. Adherence to strict patient selection and safe surgical principles are critical to ensure excellent clinical outcomes and minimize complications. Given that InhibiZone-coated device is not available in many AP countries, the use of prophylactic antibiotics pre-and post-operatively are recommended. The AMS 800 device should be prepared according to the manufacturer's guidelines and remains a cost-effective treatment for male SUI. The AMS 800 device remains the surgical benchmark for male SUI but is associated with certain mechanical limitations and a unique set of complications.

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Safety and efficacy of artificial urinary sphincter versus male slings in treatment of male urinary incontinence: Systematic review and meta-analysis

Grigoryan,

Kasyan,

Shapovalenko

et al. 2024

Continence Reports

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A cost‐utility analysis of artificial urinary sphincter versus AdVance male sling in post prostatectomy stress urinary incontinence: A publicly funded health care perspective

Abstract: AUS implantation appears to be more economical treatment strategy for severe PPSUI compared with AdVance sling for a publicly funded health care system over a 5- and 10-year time horizon.

Cited by 8 publications

References 23 publications

Treatment of male stress urinary incontinence at time of inflatable penile prosthesis placement a review of contemporary literature

Treatment of male stress urinary incontinence at time of inflatable penile prosthesis placement a review of contemporary literature

The Asia‐Pacific AMS800 artificial urinary sphincter consensus statement

Safety and efficacy of artificial urinary sphincter versus male slings in treatment of male urinary incontinence: Systematic review and meta-analysis

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