Artificial sphincters: An overview from existing devices to novel technologies

Toniolo, Ilaria; Mascolini, Maria Vittoria; Carniel, Emanuele Luigi; Fontanella, Chiara Giulia

doi:10.1111/aor.14434

Cited by 14 publications

(21 citation statements)

References 104 publications

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“…These drawbacks leave them with a lot of space for improvement. In addition, they still suffer from common complications, such as tissue atrophy, erosion, and mechanical malfunction, requiring revision surgery or complete removal 19,37,69,70 …”

Section: Discussionmentioning

confidence: 99%

“…In addition, they still suffer from common complications, such as tissue atrophy, erosion, and mechanical malfunction, requiring revision surgery or complete removal. 19,37,69,70 AUS based on electromechanical control is capable of converting electrical energy into mechanical energy during operation, and the distinguishing feature of such devices is that they are usually designed with brakes such as motors and piezoelectric pumps. The advantage of the devices is that it is well enclosed.…”

Section: Magnetically Controlled Aus Based On Novel Activationmentioning

confidence: 99%

“…This treatment method has more than 40 years of clinical experience and is mainly used for male SUI treatment 18 . There are several papers reviewing and analyzing AMS 800 with extensive clinical experience and its alternative solutions 2,19 . For AUS based on different control methods, magnetically control AUS with contactless force transfer, and no heat generation is perhaps the most promising future development direction.…”

Section: Introductionmentioning

confidence: 99%

“…18 There are several papers reviewing and analyzing AMS 800 with extensive clinical experience and its alternative solutions. 2,19 For AUS based on different control methods, magnetically control AUS with contactless force transfer, and no heat generation is perhaps the most promising future development direction. Several recent papers have reported a magnetically controlled AUS, [20][21][22] which can be rapidly implanted into the urethra of patients, and the implantation process is painless and does not require hospitalization.…”

Section: Introductionmentioning

confidence: 99%

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Magnetically controlled artificial urinary sphincter: An overview from existing devices to future developments

et al. 2023

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Background Urinary incontinence is a common clinical problem in the world today. Artificial urinary sphincter is a good treatment approach for severe urinary incontinence, which is designed to mimic the action of the human urinary sphincter and assist patients to regain urinary function. Methods There are many control methods based on artificial urinary sphincter, such as hydraulic control, electromechanical control, magnetic control, and shape memory alloy control. In this paper, the literature was first searched and documented based on PRISMA search strategy for selected specific subject terms. Then, a comparison of artificial urethral sphincters based on different control methods was conducted, and the research progress of magnetically controlled artificial urethral sphincters was reviewed, and their advantages and disadvantages were summarized. Finally, the design factors for the clinical application of magnetically controlled artificial urinary sphincter are discussed. Results As magnetic control allows for non‐contact force transfer and does not generate heat, it is proposed that magnetic control may be one of the more promising control methods. The design of future magnetically controlled artificial urinary sphincters will need a variety of considerations, including the structural design of the device, manufacturing materials, manufacturing costs, and convenience. In addition, validation of the safety and effectiveness of the device and device management are equally important. Conclusions The design of an ideal magnetically controlled artificial urinary sphincter is of great importance to enhance patient treatment outcomes. However, there are still great challenges to be faced for the clinical application of such devices.

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Section: Discussionmentioning

confidence: 99%

Section: Magnetically Controlled Aus Based On Novel Activationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Magnetically controlled artificial urinary sphincter: An overview from existing devices to future developments

et al. 2023

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“…Due to the development of implantable medical devices, artificial anal sphincters (AAS) that replace the function of the biological sphincters are considered a reasonable solution for FI. 2 Since the first implanted devices for incontinence were proposed by Christiansen in 1987, the AAS has been a focus of research in treating FI. [3][4][5][6][7][8] To evaluate the clamping sensing and fecal perception of AAS devices for humans, a series of in vitro and in vivo tests are required.…”

Section: Introductionmentioning

confidence: 99%

Simulation of artificial anal sphincter motion and interaction with intestinal environment using SOFA

Liu,

Wang,

Yan

et al. 2023

Artificial Organs

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BackgroundArtificial anal sphincter is an implantable medical device for treating fecal incontinence. Reasonable simulation facilitates the advancement of research and reduces experiments on biological tissue. However, the device's clamping motion and sensor interaction with the intestine in the simulation still require further exploration. This article presents a simulation of the artificial anal sphincter's clamping and sensing and its interaction with the intestinal environment using the Simulation Open Framework Architecture (SOFA).MethodsFirstly, the proposed simulation algorithm and its principles in SOFA are analyzed. Secondly, the clamping motion and sensor system of the artificial anal sphincter are simulated. Thirdly, a finite element model of intestine is established based on the properties of intestinal soft tissue. Finally, the in vitro experiments are performed.ResultsThe simulation results indicate that the sensor system of the artificial anal sphincter has good sensing performance during the clamping motion and fecal accumulation process. Experiments have shown that optimal sensory capabilities can be achieved as the posture of the artificial anal sphincter with a roll angle between 20° and 40°. The comparison demonstrates a mean absolute error of 10%–20% between simulation and in vitro experimental results for sensor forces, which verifies the effectiveness of the simulation.ConclusionThe proposed novel simulation achieves a more comprehensive interaction between the artificial anal sphincter motion and intestinal environment. This study may provide more effective simulation data for guidance in improving the performance of sensor perception of artificial anal sphincter for further research.

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In silico tools for mechanical analysis of extra‐ and intra‐luminal artificial urinary sphincters

Mazzucco,

Pirini,

Fontanella

et al. 2024

BJUI Compass

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ObjectivesTo analyse and compare the functionality of extraluminal and intraluminal artificial urinary sphincters (AUSs), an in silico procedure has been defined and applied. Design and reliability assessments of the AUS are typically performed using a clinical approach, which does not provide data on mechanical stimulation of urethral tissues. Mechanical stimulation may determine tissue degeneration, such as urethral atrophy or erosion, the main causes of AUS failure. In silico techniques can provide a quantitative description of stress and strain fields due to the interaction between tissues and AUS and allow investigating an extremely large number of situations, considering different configurations of AUS and urethra.Materials and MethodsComputational investigations were carried out to evaluate the mechanical reliability of the main extraluminal and intraluminal AUS, AMS 800 and Relief. The lower urinary tract was modelled based on previous experiments. The AUS models took into account the main components that interact with biological tissues. Urethra and AUS models were coupled and used to investigate mechanical stimulation of urethral tissues.ResultsIn silico simulations provide quantitative information about the mechanical stimulation of urethral tissue, such as compressive strain and stress and hydrostatic pressure, due to interaction with the AUS. Such mechanical quantities allow a comparison of reliability between extraluminal and intraluminal devices.ConclusionsThe activities define and demonstrate the effectiveness of a novel in silico approach to the design and reliability assessment of AUS devices, increasing the investigative possibilities and reducing the time, ethical and economic costs.

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Artificial sphincters: An overview from existing devices to novel technologies

Cited by 14 publications

References 104 publications

Magnetically controlled artificial urinary sphincter: An overview from existing devices to future developments

Magnetically controlled artificial urinary sphincter: An overview from existing devices to future developments

Simulation of artificial anal sphincter motion and interaction with intestinal environment using SOFA

In silico tools for mechanical analysis of extra‐ and intra‐luminal artificial urinary sphincters

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