Artificial Urinary Sphincter: Report of the 2015 Consensus Conference

Abstract

These guidelines undoubtedly constitute a reference document, which will help urologists to carefully select patients and apply the most adapted management to implantation, follow-up and trouble-shooting of the AMS800™.

Contemporary surgical devices for male stress urinary incontinence: a review of technological advances in current continence surgery

“…Published literature supports AMS 800 device as a highly durable, effective (up to 90%) and safe surgical option in male SUI with high patient satisfaction rate (44-48). Recent consensus among high volume implanters reported that AMS 800 implantation remains a highly-specialized surgery with surgical challenges and that careful patient selection and appropriate surgical care remain paramount in optimal surgical outcomes (49). …”

“…A recent multicentre study found that penoscrotal single-cuff implantation resulted in significantly higher short-term explantation rates compared to perineal single-cuff AUS (19.2% vs. 8.6%; P=0.019) and that postoperative infection rate was significantly higher after double-cuff compared to single-cuff implantation (6% vs. 13.9%; P=0.019) (50). Revision and explantation rates due to mechanical failure, urethral atrophy, infection, and cuff erosion vary considerably among published studies (46-49,51). The reported reoperation rate for AUS is around a third of the cases, with about 50% of these cases caused by mechanical complications and 50% by non-mechanical complications (46-49,51).…”

“…Revision and explantation rates due to mechanical failure, urethral atrophy, infection, and cuff erosion vary considerably among published studies (46-49,51). The reported reoperation rate for AUS is around a third of the cases, with about 50% of these cases caused by mechanical complications and 50% by non-mechanical complications (46-49,51). While the use of the double (tandem) cuff system was introduced to reduce the urethral atrophy and increase continence rate, it is associated with higher complication rates (52).…”

“…While the use of the double (tandem) cuff system was introduced to reduce the urethral atrophy and increase continence rate, it is associated with higher complication rates (52). Revisions include replacement of the malfunctioning component, cuff replacement, repositioning or downsizing due to urethral atrophy, and a second tandem cuff or transcorporal cuff placement (49,51,53,54). …”

REPLY BY THE AUTHORS: Re: Artificial urinary sphincter for urinary incontinence after radical prostatectomy: a historical cohort from 2004 to 2015

“…A report of a Consensus Conference (5), based on the most recent data available in literature as well as expert opinions, was recently published outlining a wide array of challenges. The Consensus highlights the need to inform patients about expected rates of mechanical failure, erosion and infection which would result in a re-operation rates ranging from 14.8% to 44.8%.…”