Artificial sphincter “BR - SL - AS 904” in the treatment of urinary incontinence after radical prostatectomy: efficacy, practicality and safety in a prospective and multicenter study

Abstract

Purpose: The objective of the present study is to test the efficiency and practicality of a new artificial sphincter “BR - SL - AS – 904” in the control of urinary incontinence in post - PR patients and to evaluate their complications. Patients and Methods: Fifteen patients with incontinence after one year of radical prostatectomy were included prospectively. All patients underwent artificial urethral sphincter (AUS) implant “BR - SL - AS – 904” according to established technique. Independent variables such as free urinary flow, PAD weight test, ICIQ - SF score and urinary symptoms through the IPSS score were compared in different follow-up moments. Results: Patients submitted to AUS implantation did not present trans - operative or post - operative complications related to the surgical act such as: infection, hematoma, erosion or urinary retention. Device was inert to the body during the follow-up, showing an excellent adaptation of the patients, besides the easy handling. The mean age was 68.20 years 40% of the patients had systemic arterial hypertension, 6.7% diabetes mellitus, 6.7% were hypertensive and diabetic, 13.4% were hypertensive, had diabetes and hypercholesterolemia and 26.7% patients had no comorbidities. It was evidenced that the urinary flow peak during the follow-up remained stable. Decreased averages and median PAD weight test were 135.19 to 75.72 and 106.00 to 23.50, respectively. The IPSS score decreased and the quality of life increased (12.33 to 3.40 and 2.50 to 3.20 respectively). The ICQF - SF questionnaire score also showed a decrease, ranging from 16, 71 to 7.33. Conclusion: The artificial sphincter implant “BR - SL - AS 904” was reproducible, safe and effective in the control of urinary incontinence in post - PR patients.

Artificial sphincters: An overview from existing devices to novel technologies

“…The pressure exerted on this reservoir is transmitted through the hydraulic system to the cuff, preserving urinary continence during stress-related increases in abdominal pressure. 45,75 Among the hydraulic AUSs, also the ACT™ for females and ProACT™ for males (Adjustable Continence Therapy, Uromedica, Inc., Plymouth, MN, USA) were considered in this review, even though the absence of a fluid-cuff system around the urethra as the previous devices reported. This is due to the fact that they are adjustable sphincter F I G U R E 2 Hydraulic AS devices.…”

“…This is due to the fact that they are adjustable sphincter F I G U R E 2 Hydraulic AS devices. AMS 800 (A) (reproduced with permission from Wiley, image from the technical datasheet of Boston Scientific) 12 FlowSecure (B) (image from open access paper), 42 Zephyr ZSI 375 (C) (reproduced with permission from Elsevier), 43 PUC (image from open access paper) (D), 42 VICTO, VICTO+ (E) (image from the technical datasheet of Promedon), 44 BR-SL-AS-904 (F) (image from open access paper), 45 Acticon Neosphincter (G) (courtesy of American Medical Systems, Inc., Minnetonka, MN, www.ameri canme dical syste ms.com), PAS (H) (image from open access paper), 13 AAS (I) (image from the technical datasheet of A.M.I.®), 46 and GASS (J) (reproduced with permission from Elsevier). 47 prostheses that exert an occlusive action through adjustable balloons filled with radio-opaque isotonic solution.…”

Comparison of Different Invasive Devices for the Treatment of Urinary Incontinence after Radical Prostatectomy

“…e lack of considerable postoperative results in the selected studies in terms of pad weight does not consent to evaluate the effect of the different groups of devices on this parameter. More data are available in terms of number of pad/day, and in all groups, a significant (P < 0.01) mean reduction was observed after treatment, with the lowest improvement (−2.0 (95% CI −1.43/−2.57) pad/day) in the group of bulking agents and the highest (−5.19 (95% CI Van Uhm (39) Bauer (32) Bauer (31) Bauer (12) Ferro (29) Collado (15) Collado (14) Bauer (43) Renè Yiou (30) Cestari (40) Kim (34) Correira Lima (33) Renè Yiou ( Test of θ i = θ j : Q(0) = -0.00, p = .…”

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

“…Этот модифицированный имплант имеет систему передачи жидкости из резервуара, размещенного в брюшной полости, в соединенную с ним наполняемую уретральную манжету. Данная особенность конструкции позволяет добиться удержания мочи во время повышения внутрибрюшного давления [17].…”