Current Perspectives on Complications of Surgical Treatments for Male Stress Urinary Incontinence

Shelton, Thomas M.; Brimley, Scott; Tsambarlis, Peter

doi:10.1016/j.sxmr.2019.12.003

Cited by 6 publications

(5 citation statements)

References 19 publications

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“…This is the largest study of antimicrobial use in AUS surgery to our knowledge. Approximately 32% of patients experienced a complication, and 26% required surgical revision, consistent with reported rates from other large retrospective single‐center and database studies 5,16,17 …”

Section: Discussionsupporting

confidence: 83%

“…Approximately 32% of patients experienced a complication, and 26% required surgical revision, consistent with reported rates from other large retrospective single-center and database studies. 5,16,17 Besides complications coded as "other," infectious complications appear to account for the majority of surgical revision/removal events, which explains similar findings in these models. The exception is history of diabetes.…”

Section: Device Complicationssupporting

confidence: 63%

“…The artificial urinary sphincter (AUS) is the most effective treatment for SUI and is considered the gold standard therapy with recommended use even for severe SUI after radiotherapy for prostate cancer 1 . However, despite the efficacy of AUS, 10%–40% of patients with an AUS require surgical revision after initial placement; 1%–11% of these are attributed to infection 3–5 . Infection is a particularly troublesome complication for prostheses, as these patients are even more likely to require repeat procedures if reimplantation is pursued 6–8 …”

Section: Introductionmentioning

confidence: 99%

“…1 However, despite the efficacy of AUS, 10%-40% of patients with an AUS require surgical revision after initial placement; 1%-11% of these are attributed to infection. [3][4][5] Infection is a particularly troublesome complication for prostheses, as these patients are even more likely to require repeat procedures if reimplantation is pursued. [6][7][8] The American Urological Association (AUA) first provided guidance on perioperative infection prevention in their 2008 Best Practice Policy Statement on Urologic Surgery Antimicrobial Prophylaxis, with an update in 2012 to include aztreonam as an alternative to aminoglycosides for patients with renal insufficiency.…”

Section: Introductionmentioning

confidence: 99%

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Trends over 20 years of antimicrobial prophylaxis for artificial urinary sphincter surgery

Sun

Callegari

Zhou

et al. 2023

Neurourology and Urodynamics

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Introduction and Objective Perioperative antimicrobial prophylaxis is crucial for prevention of prosthesis and patient morbidity after artificial urinary sphincter (AUS) placement. While antibiotic guidelines exist for many urologic procedures, adoption patterns for AUS surgery are unclear. We aimed to assess trends in antibiotic prophylaxis for AUS and outcomes relative to American Urological Association (AUA) Best Practice guidelines. Methods The Premier Healthcare Database was queried from 2000 to 2020. Encounters involving AUS insertion, revision/removal, and associated complications were identified via ICD and CPT codes. Premier charge codes were used to identify antibiotics used during the insertion encounter. AUS‐related complication events were found using patient hospital identifiers. Univariable analysis between hospital/patient characteristics and use of guideline‐adherent antibiotics was done via chi‐squared and Kruskal–Wallis tests. A multivariable logistic mixed effects model was used to assess factors related to the odds of complication, specifically the use of guideline‐adherent versus nonadherent regimens. Results Of 9775 patients with primary AUS surgery, 4310 (44.1%) received guideline‐adherent antibiotics. The odds of guideline‐adherent regimen use increased 7.7% per year with 53.0% (830/1565) receiving guideline‐adherent antibiotics by the end of the study period. Patients with guideline‐adherent regimens had a decreased risk of any complication (odds ratio [OR]: 0.83, 95% confidence interval [CI]: 0.74–0.93) and surgical revision (OR: 0.85, 95% CI: 0.74–0.96) within 3 months; however, no significant difference in infection within was noted (OR: 0.89, 95% CI: 0.68–1.17) within 3 months. Conclusions Adherence to AUA antimicrobial guidelines for AUS surgery appears to have increased over the last two decades. While guideline‐adherent regimens were associated with decreased risk of any complication and surgical intervention, no significant association was found with risk of infection. Surgeons appear to be increasingly following AUA recommendations for antimicrobial prophylaxis for AUS surgery, however, further level 1 evidence should be obtained to demonstrate conclusive benefit of these regimens.

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Section: Discussionsupporting

confidence: 83%

Section: Device Complicationssupporting

confidence: 63%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Trends over 20 years of antimicrobial prophylaxis for artificial urinary sphincter surgery

Sun

Callegari

Zhou

et al. 2023

Neurourology and Urodynamics

View full text Add to dashboard Cite

show abstract

“…Previous studies have shown that the most common surgery for UI in men are male slings and artificial urinary sphincters, but there remains complications such as infection, erosion and bring enormous healthcare costs (Shelton et al, 2020). Besides, men with LUTS seeking for available health care have their treatment preference, conservative and less risky treatment options that have fewer sexual side effects and are primarily effective, such as alternative therapies, lifestyle interventions, behavioural or physical therapies (Malde et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

Non‐pharmacological and nonsurgical interventions in male urinary incontinence: A scoping review

Zhang

Hou

Zhang

et al. 2023

Journal of Clinical Nursing

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AimsTo describe and synthesize non‐pharmacological and nonsurgical interventions for male urinary incontinence from the existing literature.MethodsA scoping review was conducted following the methodology suggested by Arksey and O'Malley: (1) identification of the research questions; (2) identification of relevant studies using a three‐step search recommended by JBI: an initial search within PubMed and CINAHL, a comprehensive literature search within PubMed, CINAHL, EMBASE, PsycINFO, Cochrane Library, and literature search of references lists; (3) study selection; (4) data extraction and charting; (5) collation, summarization, and reporting of the results. The PRISMA‐ScR Checklist was used to report.ResultsA total of 4602 studies were identified, of which 87 studies were included. Approximately 78% were randomized controlled trials. More than 88% of the participants were men with prostate cancer. Exercising pelvic floor muscles 30 times per day for 12 weeks was the most frequently reported. Parameters of electrical stimulation were typically set up to 50 Hz and 300 μs for frequency and width of pulse, respectively, and lasted for 15 min. Pure pelvic floor muscle training, Pilates, Yoga, whole body vibration, diaphragm/abdominal muscle training, micturition interruption exercise, acupuncture, and auriculotherapy showed positive effects on reducing urinary incontinence.ConclusionThe findings suggested implementing pelvic floor muscle training alone before or after surgery can both prompt the recovery of continence in men after prostate cancer surgery. The decision to use biofeedback or electrical stimulation to enhance the therapeutic effect of pelvic floor muscle training should be approached with caution. More rigorous designed studies are needed to validate the effectiveness of Traditional Chinese Medicine techniques and diverse novel methods.Relevance to clinical practicePhysicians and nurses need to be up to date on the latest evidence‐based non‐pharmacological and nonsurgical interventions in male urinary incontinence and select appropriate interventions based on available medical resources and patient preferences.

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Prise en charge de l’incontinence urinaire d’effort non-neurogène

Grégoris,

Abboud,

Valerio

et al. 2024

Urol. Prax.

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RésuméL’incontinence urinaire d’effort affecte hommes et femmes, causant une perte involontaire d’urine lors de l’augmentation de la pression abdominale. Elle résulte de l’hypermobilité urétrale et/ ou de l’insuffisance sphinctérienne intrinsèque, avec un coût social et économique important en Europe. Sa prise en charge inclut des méthodes conservatrices et chirurgicales, dont ces dernières seront abordées dans cet article.Chez les femmes, les traitements incluent l’utilisation d’agents comblants pour améliorer la coaptation urétrale, les bandelettes sous-urétrales pour compenser la faiblesse des ligaments pubo-urétraux, la bandelette autologue pour les cas complexes ou après échec d’une bandelette synthétique, la suspension rétropubienne (colposuspension selon Burch) pour restaurer le support pelvien et le sphincter artificiel pour les cas d’insuffisance sphinctérienne intrinsèque ou après échec chirurgical.Chez les hommes, les options chirurgicales pour l’incontinence urinaire post-chirurgie urétro-prostatique incluent l’injection d’agents comblants pour améliorer la coaptation urétrale, les bandelettes sous-urétrales pour soutenir l’urètre bulbaire, et le sphincter artificiel pour les cas modérés à sévères, offrant une continence efficace mais avec un taux de complications plus élevé.Ces options chirurgicales présentent des avantages et des limites spécifiques, nécessitant une évaluation personnalisée. Les avancées techniques continuent d’offrir de bonnes perspectives pour le traitement de l’incontinence urinaire d’effort, soulignant l’importance d’une évaluation standardisée et d’un suivi rigoureux pour comparer efficacement les différentes méthodes.

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Current Perspectives on Complications of Surgical Treatments for Male Stress Urinary Incontinence

Cited by 6 publications

References 19 publications

Trends over 20 years of antimicrobial prophylaxis for artificial urinary sphincter surgery

Trends over 20 years of antimicrobial prophylaxis for artificial urinary sphincter surgery

Non‐pharmacological and nonsurgical interventions in male urinary incontinence: A scoping review

Prise en charge de l’incontinence urinaire d’effort non-neurogène

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