Comparison of Outcomes for Adjustable Bulbourethral Male Sling and Artificial Urinary Sphincter After Previous Artificial Urinary Sphincter Erosion

Tuygun, Can; İmamoğlu, Abdurrahim; Gücük, Adnan; Göktuğ, Göksel; Demirel, Fatih

doi:10.1016/j.urology.2008.10.073

Cited by 39 publications

(21 citation statements)

References 20 publications

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“…One study of interest conducted by Tuygun and colleagues retrospectively compared the Argus (Promedon SA, Cordoba, Argentina) sling to the AMS 800 (AMS, Minnetonka, Minnesota) AUS [46]. A total of 16 patients with prior AUS erosions were treated with either ARS ( n = 8) or repeat AUS ( n = 8).…”

Section: Resultsmentioning

confidence: 99%

Male Stress Urinary Incontinence: A Review of Surgical Treatment Options and Outcomes

Trost

Elliott

2012

Advances in Urology

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Introduction and Objective. Iatrogenic male stress urinary incontinence (SUI) affects a percentage of men undergoing urologic procedures with a significant impact on quality of life. The treatment of male SUI has evolved significantly with multiple current options for treatment available. The current paper discusses preoperative evaluation of male SUI, available surgical options with reported outcomes, and postoperative complication management. Methods. A pubMed review of available literature was performed and summarized on articles reporting outcomes of placement of the artificial urinary sphincter (AUS) or male slings including the bone anchored sling (BAS), retrourethral transobturator sling (RTS), adjustable retropubic sling (ARS), and quadratic sling. Results. Reported rates of success (variably defined) for BAS, RTS, ARS, and AUS are 36–67%, 9–79%, 13–100%, and 59–91% respectively. Complications reported include infection, erosion, retention, explantation, and transient pain. Male slings are more commonly performed in cases of low-to-moderate SUI with decreasing success with higher degrees of preoperative incontinence. Conclusions. An increasing number of options continue to be developed for the management of male SUI. While the AUS remains the gold-standard therapy for SUI, male sling placement is a proven viable alternative therapy for low-to-moderate SUI.

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Section: Resultsmentioning

confidence: 99%

Male Stress Urinary Incontinence: A Review of Surgical Treatment Options and Outcomes

Trost

Elliott

2012

Advances in Urology

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“…reported a comparison of adjustable bulbourethral sling placement and AUS revision in 16 patients after previous AUS erosion. A total of 50% of the patients with the sling and 75% of patients undergoing repeat AUS were cured or improved using validated questionnaires …”

Section: Special Considerationsmentioning

confidence: 99%

Artificial urinary sphincter for post‐prostatectomy incontinence: A review

James

McCammon

2014

Int J of Urology

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Abstract:The artificial urinary sphincter remains the gold standard for treatment of postprostatectomy urinary incontinence. The AMS 800 (American Medical Systems, Minnetonka, MN, USA) is the most commonly implanted artificial urinary sphincter. Having been on the market for almost 40 years, there is an abundance of literature regarding its use, but no recent review has been published. We reviewed the current literature regarding the indications, surgical principles, outcomes and complications of artificial urinary sphincter implantation for stress urinary incontinence after prostatectomy. A PubMed search was carried out for articles on the artificial urinary sphincter from 1995 to present. The review was centered on articles related to the use of the AMS 800 for stress urinary incontinence in males after prostatectomy. Relevant articles were reviewed. The majority of patients will achieve social continence (1 pad per day) after artificial urinary sphincter implantation; however, rates of total continence (no pad usage) are significantly lower. Patient satisfaction outcomes average greater than 80% in most series. Potential complications requiring reoperation include infection (0.5-10.6%) and urethral erosion (2.9-12%). Revision surgeries are most commonly as a result of urethral atrophy, which ranges from 1.6 to 11.4%. The 5-year Kaplan-Meier freedom from reoperation ranges from 50 to 79%, while the 10-year Kaplan-Meier freedom from mechanical failure is 64%. The artificial urinary sphincter is a reliable device with good outcomes. As expected with any prosthetic device, complications including mechanical failure, infection, erosion and recurrent incontinence remain significant concerns. Despite known complications, the patient satisfaction rates after artificial urinary sphincter implantation remain high. Appropriate patient counseling and adherence to surgical principles are imperative.

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“…Although various continence promoting devices, most notably bone anchored, 1 transobturator 2 and adjustable male slings, 3 have been used as a treatment modality for mild to moderate SUI, the AUS is considered the gold standard for the treatment of severe SUI. 4 …”

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confidence: 99%

Artificial Urinary Sphincter Placement in Compromised Urethras and Survival: A Comparison of Virgin, Radiated and Reoperative Cases

et al. 2014

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Purpose Although long-term outcomes after initial placement of artificial urinary sphincters are established, limited data exist comparing sphincter survival in patients with compromised urethras (prior radiation, artificial urinary sphincter placement or urethroplasty). We evaluated artificial urinary sphincter failure in patients with compromised and noncompromised urethras. Materials and Methods We performed a retrospective analysis of 86 sphincters placed at a single institution between December 1997 and September 2012. We assessed patient demographic, comorbid disease and surgical characteristics. All nonfunctioning, eroded or infected devices were considered failures. Results Of the 86 patients reviewed 67 (78%) had compromised urethras and had higher failure rates than the noncompromised group (34% vs 21%, p=0.02). Compared to the noncompromised group, cases of prior radiation therapy (HR 4.78; 95% CI 1.27, 18.04), urethroplasty (HR 8.61; 95% CI 1.27, 58.51) and previous artificial urinary sphincter placement (HR 8.14; 95% CI 1.71, 38.82) had a significantly increased risk of failure. The risk of artificial urinary sphincter failure increased with more prior procedures. An increased risk of failure was observed after 3.5 cm cuff placement (HR 8.62; 95% CI 2.82, 26.36) but not transcorporal placement (HR 1.21; 95% CI 0.49, 2.99). Conclusions Artificial urinary sphincter placement in patients with compromised urethras from prior artificial urinary sphincter placement, radiation or urethroplasty had a statistically significant higher risk of failure than placement in patients with noncompromised urethras. Urethral mobilization and transection performed during posterior urethroplasty surgeries likely compromise urethral blood supply, predisposing patients to failure. Patients with severely compromised urethras from multiple prior procedures may have improved outcomes with transcorporal cuff placement rather than a 3.5 cm cuff.

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Comparison of Outcomes for Adjustable Bulbourethral Male Sling and Artificial Urinary Sphincter After Previous Artificial Urinary Sphincter Erosion

Cited by 39 publications

References 20 publications

Male Stress Urinary Incontinence: A Review of Surgical Treatment Options and Outcomes

Male Stress Urinary Incontinence: A Review of Surgical Treatment Options and Outcomes

Artificial urinary sphincter for post‐prostatectomy incontinence: A review

Artificial Urinary Sphincter Placement in Compromised Urethras and Survival: A Comparison of Virgin, Radiated and Reoperative Cases

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