Female Urinary Incontinence and Artificial Urinary Sphincter: Study of Efficacy and Risk Factors for Failure and Complications

Vayleux, Bertrand; Rigaud, J.; Luyckx, F.; Karam, Georges; Glémain, Pascal; Bouchot, Olivier; Normand, L. Le

doi:10.1016/j.eururo.2011.03.006

Cited by 68 publications

(52 citation statements)

References 10 publications

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“…The criteria used in the studies with AUS to define continence were represented in Table 2. Discrepancies exist in the definition of continence reported in the main series [34][35][36][37][38][39][40][41][42][43][44]. Furthermore, subjective outcomes were rarely reported.…”

Section: Ausmentioning

confidence: 74%

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Outcome measures for stress urinary incontinence treatment: Can we minimally agree?

Phé

Chartier‐Kastler

2015

World J Urol

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Section: Ausmentioning

confidence: 74%

“…Validated quality of life questionnaires were never used. Only subjective improvement assessed by asking the patients was sometimes reported [34,36,38,43]. Sexual function was never investigated.…”

Section: Ausmentioning

confidence: 99%

Outcome measures for stress urinary incontinence treatment: Can we minimally agree?

Phé

Chartier‐Kastler

2015

World J Urol

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“…With a mean followup of 6 years, 74% of the patients used (0 or 1 pad/day) and 65% used no pads. 18 The authors and expert review panel do not routinely use these approaches; however, they may be appropriate in very select cases.…”

Section: Surgical Interventionmentioning

confidence: 99%

Management of patients with stress urinary incontinence after failed midurethral sling

Kavanagh¹,

Sanaee²,

Carlson³

et al. 2017

CUAJ

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Surgical failure rates after midurethral sling (MUS) procedures are variable and range from approximately 8-57% at five years of followup. The disparity in long-term failure rates is explained by a lack of long-term followup and lack of a clear definition of what constitutes failure. A recent Cochrane review illustrates that no high-quality data exists to recommend or refute any of the different management strategies for recurrent or persistent stress urinary incontinence (SUI) after failed MUS surgery. Clinical evaluation requires a complete history, physical examination, and establishment of patient goals. Conservative treatment measures include pelvic floor physiotherapy, incontinence pessary dish, commercially available devices (Uresta ® , Impressa ® ), or medical therapy. Minimally invasive therapies include periurethral bulking agents (bladder neck injections) and sling plication. Surgical options include repeat MUS with or without mesh removal, salvage autologous fascial sling or Burch colposuspension, or salvage artificial urinary sphincter insertion. In this paper, we present the available evidence to support each of these approaches and include the management strategy used by our review panel for patients that present with SUI after failed midurethral sling. IntroductionWith shorter recovery times and comparable efficacy, the midurethral sling (MUS) has surpassed the Burch colposuspension as the "gold standard" treatment for stress urinary incontinence (SUI); however, some patients will not be cured after MUS surgery and currently, there is no consensus on how to manage these patients. This constitutes a major problem not only for the patient, but also for the clinician who is faced with choosing a second surgical procedure with the best possible outcome. Options can include placement of a second synthetic MUS or an autologous sling, such as a pubovaginal sling (PVS). Furthermore, there is no consensus about whether the previously inserted MUS should be excised or if a second tape should simply be placed over the existing tape. The decision on whether to use a sling inserted via an alternative route (retropubic vs. transobturator) also has not been addressed. ranging from 62-98% in the TOR group and from 71-97% in the RPR group. Fewer trials reported medium-term (one to five years) and longer-term (over five years) data, but subjective cure was similar between the groups (RR 0.97; 95% CI 0.87-1.09; five trials, 683 women; and RR 0.95; 95% CI 0.80-1.12; four trials, 714 women). In the long-term, subjective cure rates were similar and ranged from 43-92% in the TOR group and from 51-88% in the RPR group. 2The disparity in long-term failure rates is explained by a lack of long-term followup and lack of a clear definition of what constitutes failure. In the above Cochrane review, only four of 55 included studies actually provided information regarding leakage and adverse events at five years. Additionally, "failure" may be defined differently. Failure can include: persistence of bothersome SUI; cure...

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“…More recent series reports demonstrate the safety, efficacy and complication rates associated with female AUS implantation. (Chung et al 2010;Vayleux et al 2011) Importantly, while there is a high proportion of patients that continue to use the AUS after implantation, about 50% of them have required revision or replacement, usually within the first several years of implantation. Continence rate in these two studies indicates 65-70% for no pads and 73.5-83% for 0 to 1 pad per day.…”

Section: Artificial Urinary Sphinctermentioning

confidence: 99%

“…(Light & Scott 1985) The initial use of the AUS in women with incontinence was described in 1985 (Light & Scott 1985) and has since been well documented in the literature. (Vayleux et al 2011) Costa and colleagues evaluated the efficacy of the AMS 800 AUS in women with Type III incontinence and a negative Marshall test. (Costa et al 2001) They described a modified surgical procedure through an abdominal approach.…”

Section: Artificial Urinary Sphinctermentioning

confidence: 99%

Refractory Stress Urinary Incontinence

Lenherr¹,

Mourtzinos²

2012

Urinary Incontinence

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Female Urinary Incontinence and Artificial Urinary Sphincter: Study of Efficacy and Risk Factors for Failure and Complications

Cited by 68 publications

References 10 publications

Outcome measures for stress urinary incontinence treatment: Can we minimally agree?

Outcome measures for stress urinary incontinence treatment: Can we minimally agree?

Management of patients with stress urinary incontinence after failed midurethral sling

Refractory Stress Urinary Incontinence

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