Decline in artificial urinary sphincter survival in modern practice—do we treat a different patient?

Farag, Fawzy; Doelen, Maarten J. van der; Breda, Jetske van; D’Hauwers, Kathleen; Heesakkers, John

doi:10.1002/nau.23110

Cited by 6 publications

(9 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Other authors, aligned with our results and from different international locations, have recently also reported concern with the AUS because of its high revision and explantation rates due to mechanical failure, urethral atrophy, infection, erosion, etc (3, 4). …”

supporting

confidence: 90%

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

et al. 2017

View full text Add to dashboard Cite

supporting

confidence: 90%

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

et al. 2017

View full text Add to dashboard Cite

“…Therefore in our study, we defined efficacy as dry rate (DR): namely 0 pad/day. The rate of surgical revision (SR) was defined as the need for surgery due to recurrent incontinence or complications …”

Section: Methodsmentioning

confidence: 99%

“…The rate of surgical revision (SR) was defined as the need for surgery due to recurrent incontinence or complications. 25 The following variables were studied as potential predictors for efficacy (dry rate) or freedom from surgical revision: age, presence of diabetes mellitus (DM), use of anticoagulation therapy, previous incontinence surgery (PIS), previous pelvic radiotherapy (RT), use of a double cuff, cuff size, institutional case load (ICL-total number of cases per center in the whole time lapse). Moreover a further subanalyis on the association between the average number of cases per center per year and dry rate and freedom from surgical revision was performed.…”

Section: Methodsmentioning

confidence: 99%

“…Based on retrospective and prospective single institution cohort studies, the AUS procedure has a high satisfaction rate (>80% over 4 years), which, however, is tempered by high revision rates (14‐44% over 2 years) . Indeed, only two prospective studies, accounting for 125 patients with a follow up of >12 months, have been published . Therefore, risk factors for efficacy or revisions rates remain uncertain.…”

Section: Introductionmentioning

confidence: 99%

“…[7][8][9][10][11][12][13][14][15][16][17][18][19][20] Indeed, only two prospective studies, accounting for 125 patients with a follow up of >12 months, have been published. [21][22][23][24][25] Therefore, risk factors for efficacy or revisions rates remain uncertain. Moreover, only 17% of primary implants are performed by high volume centers (performing more than 10 implants per year).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Efficacy and safety of artificial urinary sphincter (AUS): Results of a large multi‐institutional cohort of patients with mid‐term follow‐up

Tutolo

Cornu

Bauer

et al. 2018

Neurourology and Urodynamics

Self Cite

View full text Add to dashboard Cite

Aims To assess efficacy and safety as well as predictive factors of dry rate and freedom from surgical revision in patients underwent AUS placement. The artificial urinary sphincter (AUS) is still considered the standard for the treatment of moderate to severe post‐prostatectomy stress urinary incontinence (SUI). However, data reporting efficacy and safety from large series are lacking. Methods A multicenter, retrospective study was conducted in 16 centers in Europe and USA. Only primary cases of AUS implantation in non‐neurogenic SUI after prostate surgery, with a follow‐up of at least 1 year were included. Efficacy data (continence rate, based on pad usage) and safety data (revision rate in case of infection and erosion, as well as atrophy or mechanical failure) were collected. Multivariable analyses were performed in order to investigate possible predictors of the aforementioned outcomes. Results Eight hundred ninety‐two men had primary AUS implantation. At 32 months mean follow‐up overall dry rate and surgical revision were 58% and 30.7%, respectively. Logistic regression analysis showed that patients without previous incontinence surgery had a higher probability to be dry after AUS implantation (OR: 0.51, P = 0.03). Moreover institutional case‐load was positively associated with dry rate (OR: 1.18; P = 0.005) and freedom from revision (OR: 1.51; P = 0.00). Conclusions The results of this study showed that AUS is an effective option for the treatment of SUI after prostate surgery. Moreover previous incontinence surgery and low institutional case‐load are negatively associated to efficacy and safety outcomes.

show abstract

High/low‐volume center experience predicts outcome of AMS 800 in male stress incontinence: Results of a large middle European multicenter case series

Queissert

Hüsch

Kretschmer

et al. 2020

Neurourology and Urodynamics

View full text Add to dashboard Cite

Aim To analyze the influence of implantation volume of artificial sphincters (AMS 800) on outcome in a large central European multicenter cohort study. Methods As part of the DOMINO (Debates on Male Incontinence) project, the surgical procedures and outcomes were retrospectively analyzed in a total of 473 patients who received an artificial sphincter (AMS 800) between 2010 and 2012. Clinics that implanted at least 10 AMS 800 per year were defined as high‐volume centers. Results Sixteen centers had a mean rate of 9.54 AMS 800/y of which five clinics were identified as high‐volume centers. They implanted significantly more double cuffs (55% vs 12.1%; P < .001), used the perineal approach significantly more often (78% vs 67.7%; P = .003) and chose larger mean cuff sizes (4.63 cm vs 4.42 cm; P = .002). With a mean follow‐up of 18 months, the revision rate was significantly higher at low‐volume centers (38.5% vs 26.7%; P = .037), urethral erosion being the main reason for revision. Social continence (0‐1 pads/24 h) was achieved significantly more often in high‐volume centers (45.5% vs 24.2%; P = .002). Conclusions Our study showed significantly better continence results and lower revision rates at high‐volume centers, confirming earlier results that are still true in this decade. We, therefore, recommend surgery for male incontinence at qualified centers.

show abstract

Decline in artificial urinary sphincter survival in modern practice—do we treat a different patient?

Abstract: In modern urological practice, more exposure to RT and previous surgeries for incontinence are associated with increased risk for revision with decline in AUS survival.

Cited by 6 publications

References 21 publications

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

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

Efficacy and safety of artificial urinary sphincter (AUS): Results of a large multi‐institutional cohort of patients with mid‐term follow‐up

High/low‐volume center experience predicts outcome of AMS 800 in male stress incontinence: Results of a large middle European multicenter case series

Contact Info

Product

Resources

About