Antibiotic Coating of the Artificial Urinary Sphincter (AMS 800): Is it Worthwhile?

Hüsch, Tanja; Kretschmer, Alexander; Thomsen, Frederik Birkebæk; Kronlachner, Dominik; Kurosch, M.; Obaje, Alice; Anding, Ralf; Pottek, Tobias; Rose, Alison; Olianas, Roberto; Friedl, Alexander; Hübner, W.; Homberg, Roland; Pfitzenmaier, Jesco; Grein, Ulrich; Queissert, Fabian; Naumann, Carsten Maik; Schweiger, Josef; Wotzka, Carola; Nyarangi‐Dix, Joanne; Hofmann, Torben; Ulm, Kurt; Bauer, Ricarda M.; Haferkamp, Axel

doi:10.1016/j.urology.2016.12.056

Cited by 27 publications

(11 citation statements)

References 29 publications

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“…In 2007, AMS introduced the InhibiZone‐coated AUS (rifampin and minocycline hydrochloride coating). Nevertheless, a recently published study showed that the antibiotic coating had no significant impact on infection or explantation rates in a retrospective cohort of 47 patients with InhibiZone and 258 without InhibiZone coating …”

Section: Summary Of Current Literaturementioning

confidence: 98%

Surgical treatment of post‐prostatectomy stress urinary incontinence in adult men: Report from the 6th International Consultation on Incontinence

Averbeck

Woodhouse

Comiter

et al. 2018

Neurourology and Urodynamics

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Aims:To report the recommendations of the 6th International Consultation on Incontinence (ICI) on post-prostatectomy urinary incontinence. Methods: The 6th ICI committee on surgical treatment of urinary incontinence in men assessed and reviewed the outcomes of surgical therapy and updated the prior recommendations published in 2013. Articles from peer-reviewed journals, abstracts from scientific meetings, and literature searches by hand and electronically formed the basis of this review. The resulting guidelines were presented at the 2016 ICI meeting in Tokyo, Japan. Results: Voiding diary and pad tests are valuable for assessing quantity of leakage.Cystoscopy and/or urodynamics may be useful in guiding therapy depending on the type of incontinence and presumed etiology. Artificial Urinary Sphincter (AUS) is the preferred treatment for men with moderate to severe stress urinary incontinence (SUI) after RP. Male slings are an acceptable approach for men with mild to moderate SUI.Much discussion centers on the definition of moderate SUI. Injectable agents have a poor success rate in men with SUI. Options for recurrent SUI due to urethral atrophy after AUS implantation include changing the pressure balloon, downsizing the cuff and increasing the amount of fluid in the system. Infection and/or erosion demand surgical removal or revision of all or part of the prosthesis. Conclusions: Although there are several series reporting the outcomes of different surgical interventions for PPUI, there is still a need for prospective randomized clinical trials. Recommendations for future research include standardized workup and outcome measures, and complete reporting of adverse events at long-term.

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Section: Summary Of Current Literaturementioning

confidence: 98%

Surgical treatment of post‐prostatectomy stress urinary incontinence in adult men: Report from the 6th International Consultation on Incontinence

Averbeck

Woodhouse

Comiter

et al. 2018

Neurourology and Urodynamics

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“…For example, the AMS 800 implant has an antibiotic-impregnated coating (InhibiZone), with rifampin and minocycline. While this technology has shown increased efficacy in reducing infectious complications among PP implants, a recent retrospective analysis found no significant impact on infections or explantation rates in their multicenter cohort of 305 patients (12,21). A study by Adamsky et al also found that routine use of postoperative oral antibiotics does not reduce the odds of AUS explantations, and this practice should be reconsidered in the era of increasing bacterial resistance (22).…”

Section: Discussionmentioning

confidence: 98%

“…Due to the detriment and burden of this complication towards patients and the healthcare system, there has been significant efforts geared towards decreasing such risk for device infection. Meticulous attention to intraoperative sterile technique, implementation of antimicrobial adjuncts such as use of broad-spectrum intravenous antibiotics, irrigation lavage, and even use of antibiotic-impregnated AUS devices has been developed to decrease the risk of biofilm formation (11,12). Specific to revision procedures, studies from PP research by Henry et al have previously documented the importance of performing a thorough and vigorous washout of the implant space with antiseptic irrigation to dislodge any pre-existing biofilm that may have been sequestered during the initial implantation (13,14).…”

Section: Discussionmentioning

confidence: 99%

Characterizing the biofilm of artificial urinary sphincters (AUS)

Leong¹,

Ancira²,

Bulafka³

et al. 2023

Transl Androl Urol

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Background: There is a paucity of data regarding the bacterial colonization on artificial urinary sphincter (AUS) devices following revision surgery. We aim to evaluate the microbial compositions of explanted AUS devices identified on standard culture at our institution.Methods: Twenty-three AUS devices explanted were included in this study. During revision surgery, aerobic and anaerobic culture swabs are taken from the implant, capsule, fluid surrounding the device, and biofilm, if present. Culture specimens are sent to the hospital laboratory for routine culture evaluation immediately upon case completion. Differences in number of microorganism species detected across samples (richness) against demographic variables were determined through backwards selection of all variables using analysis of variance (ANOVA). We assessed the prevalence (how many times each species occurred) of microbial culture species. Statistical analyses were performed using the statistical package in R (version 4.2.1).Results: Cultures reported positive results in 20 (87%) cases. Coagulase-negative staphylococci were the most commonly identified bacteria among explanted AUS devices (n=16, 80%). Among two of the four infected/eroded implants, more virulent organisms such as Escherichia coli and fungal species such as Candida albicans were identified. The mean number of species identified amongst culture positive devices was 2.15±0.49. The number of unique bacteria identified per sample was not significantly associated with demographic variables including race, ethnicity, age at revision, smoking history, duration of implantation, etiology for explantation, and concomitant medical comorbidities. Conclusions:The majority of AUS devices removed for non-infectious reasons harbor organisms on traditional culture at the time of explantation. The most commonly identified bacteria in this setting is coagulase-negative staphylococci, which may be a result of bacterial colonization introduced at the time of implant. Conversely, infected implants may harbor microorganisms with higher virulence including fungal elements. Bacterial colonization or biofilm formation on implants may not necessarily equate to clinically infected devices. Future studies with more sophisticated technology, such as next-generation sequencing or extended cultures, may evaluate microbial compositions of biofilm at a more granular level to understand its role in device infections.

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“…Последнее встречается менее чем у 2 % пациентов в медицинских центрах с большим практическим опытом внедрения ИМС [39]. По другим данным, применение ИМС с антибактериальным покрытием не продемонстрировало значительного эффекта в отношении протезной инфекции [12,40,41]. B. J. Linder и соавт.…”

Section: осложнения после имплантации искусственного мочевого сфинктераunclassified

Implantation of an artificial urinary sphincter for urinary incontinence after radical prostatectomy (current aspects)

Ramazanov

Ахвледиани

Savchenko

et al. 2022

Androl. genit. hir.

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Stress urinary incontinence is a debilitating condition for men, caused in most cases by radical prostatectomy. Implantation of an artificial urinary sphincter is the “golden standard” of operative correction of this pathological condition in intermediate and severe cases. The article present literature review on comparative effectiveness and safety of implantation of an artificial urinary sphincter in men.The study objective is to study the current concepts of implantation of an artificial urinary sphincter in males, as well as its effectiveness and safety.Literature search was performed using PubMed/Medline and SCOPUS databases with the following key words: stress urinary incontinence, radical prostatectomy, artificial urinary sphincter. Inclusion criteria for the studies were follow-up longer than 12 months and definition of successful result as use of 1 or less liner a day; current studies on effectiveness of prosthesis implantation with large patient population were also included. Special focus was made on the historical development of artificial sphincters, problems of comparison of the effectiveness of male slings and artificial urinary sphincter, as well as simultaneous implantation of a sphincter and a penile prosthesis. We have used 43 articles complying with the inclusion criteria, our aim, and objectives.In the considered literature, effectiveness and safety of implantation were studied primarily (70 %) for the AMS 800 implant. It was noted that the frequency of revisions of its implantation can reach 30 %. For other models of artificial sphincters, the data is sparce. Comparison of the effectiveness of artificial sphincter and male sling implantations mostly was performed for patient groups with incomparable severity of urinary incontinence. Patients’ preferences and cost had the largest effect on the choice of single-step or subsequent implantation of a penile prosthesis and an artificial urinary sphincter.Implantation of АМS 800 is an effective but not perfectly safe method of operative treatment of stress urinary incontinence in males. Development and study of new prostheses of this category are necessary.

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Antibiotic Coating of the Artificial Urinary Sphincter (AMS 800): Is it Worthwhile?

Cited by 27 publications

References 29 publications

Surgical treatment of post‐prostatectomy stress urinary incontinence in adult men: Report from the 6th International Consultation on Incontinence

Surgical treatment of post‐prostatectomy stress urinary incontinence in adult men: Report from the 6th International Consultation on Incontinence

Characterizing the biofilm of artificial urinary sphincters (AUS)

Implantation of an artificial urinary sphincter for urinary incontinence after radical prostatectomy (current aspects)

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