Overactive bladder and urgency urinary incontinence in men undergoing artificial urinary sphincter placement

Jahromi, Mona S.; Engle, Kyrra; Furlong, Daniel; Méndez, Alejandra Guevara; Gomez, Christopher

doi:10.1002/nau.24378

Cited by 11 publications

(9 citation statements)

References 8 publications

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“…The results of the search strategy and the number of records at each stage are presented in Figure 1. A total of 18 studies met the inclusion criteria and were reviewed in our study (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30). Details of the included studies are presented in Table 1.…”

Section: Resultsmentioning

confidence: 99%

“…We were able to extract data on the absence of urinary incontinence after AUS placement from eight studies ( 14 , 17 , 18 , 22 , 23 , 25 , 28 , 29 ). Comparing data of 281 patients with a history of RT vs. 489 patients without RT, we noted statistically significant reduced odds of the absence of incontinence in the RT group (OR: 0.35 95% CI: 0.21, 0.59 I 2 = 51% p < 0.0001) ( Figure 2 ).…”

Section: Resultsmentioning

confidence: 99%

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Impact of Radiation Therapy on Outcomes of Artificial Urinary Sphincter: A Systematic Review and Meta-Analysis

Zhang

2022

Front. Surg.

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BackgroundTo compare incontinence rates and complications in patients receiving artificial urinary sphincter (AUS) with or without radiotherapy (RT).MethodsPubMed, Embase, ScienceDirect, CENTRAL, and Google Scholar databases were searched for studies comparing outcomes of AUS between patients with and without RT. Search limits were from 1st January 2002 to 15th September 2021.ResultsEighteen studies were included. Meta-analysis revealed statistically significant reduced odds of the absence of incontinence in the RT group (OR: 0.35 95% CI: 0.21, 0.59 I2 = 51% p < 0.0001) as compared to the no-RT group. We also noted statistically significant increased risk of revision surgery in the RT group (OR: 1.74 95% CI: 1.16, 2.60 I2 = 73% p = 0.07). There was increased risk of infections (OR: 2.51 95% CI: 1.00, 6.29 I2 = 46% p = 0.05) and erosions (OR: 2.00 95% CI: 1.15, 3.45 I2 = 21% p = 0.01) in the RT group, but the difference was significant only for erosions. Meta-analysis revealed a statistically significant increased risk of explantation in patients with RT (OR: 3.00 95% CI: 1.16, 7.75 I2 = 68% p = 0.02) but there was no difference in the risk of urethral atrophy (OR: 1.18 95% CI: 0.47, 2.94 I2 = 46% p = 0.72) and mechanical failure (OR: 0.90 95% CI: 0.25, 3.27 I2 = 54% p = 0.87) between the two groups.ConclusionsOur meta-analysis of recent studies indicates that RT significantly reduces the odds of achieving complete continence after AUS placement. History of RT does not increase the risk urethral atrophy or mechanical failure in patients with AUS. However, the risk of revision surgery, erosions and explantations is significantly increased in patients with RT with a non-significant but increased tendency of infections.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier: NCT02612389.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Impact of Radiation Therapy on Outcomes of Artificial Urinary Sphincter: A Systematic Review and Meta-Analysis

Zhang

2022

Front. Surg.

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“…[5][6][7][8] In contrast, other studies reported that a history of RT was associated with significantly worse outcomes, including continent status and complications after AUS implantation. [9][10][11][12][13] To date, there have been no studies investigating the impact of a history of pelvic RT on LUTS other than UI after AUS implantation.…”

Section: Introductionmentioning

confidence: 99%

Longitudinal deterioration in lower urinary tract symptoms after artificial urinary sphincter implantation in patients with a history of pelvic radiation therapy

Kataoka,

Yokoyama,

Waseda

et al. 2023

LUTS

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ObjectivesTo evaluate longitudinal changes in lower urinary tract symptoms (LUTS) after artificial urinary sphincter (AUS) implantation in patients undergoing radiation therapy (RT) in comparison to those in non‐irradiated patients.MethodsThis retrospective study included 20 and 51 patients with and without a history of pelvic RT (RT and non‐RT group, respectively) who were treated with primary AUS implantation for post‐radical prostatectomy incontinence between 2010 and 2020. Longitudinal changes in the International Consultation on Incontinence Questionnaire‐Short Form (ICIQ‐SF), the International Prostate Symptom Score (IPSS), and the Overactive Bladder Symptom Score (OABSS) were calculated with a linear mixed model.ResultsIn the RT and non‐RT group, 18 (90%) and 48 (94%) patients achieved social continence, defined as daily pad use ≤1 at 1 month after activation of AUS, respectively (p = .555). During the mean follow‐up of 38 months, ICIQ‐SF, IPSS, and OABSS significantly improved after AUS implantation in both the RT and non‐RT groups. In the RT group, ICIQ‐SF, IPSS, and OABSS subsequently deteriorated with a slope of 0.62/year (p = .010), 0.55/year (p = .025), and 0.30/year (p = .007), respectively. In the non‐RT group, no significant longitudinal changes in subsequent IPSS and OABSS were observed, although ICIQ‐SF significantly deteriorated (0.43/year, p = .006). Comparing between the groups, the slopes of IPSS and OABSS were significantly greater in the RT group than in the non‐RT group (p < .001, and .015, respectively).ConclusionsLongitudinal deterioration in LUTS that improved immediately after AUS implantation was observed in patients with a history of pelvic RT, but not in patients without a history of pelvic RT.

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“…For those who have symptomatic benign prostatic enlargement, appropriate treatment should be undertaken too. Detrusor overactivity and poorly compliant bladder should be treated adequately before the AUS surgery, 27 , 28 although intravesical botulinum therapy can be administered using flexible cystoscopy in patients with an in‐situ AUS.…”

Section: Main Recommendationsmentioning

confidence: 99%

The Asia‐Pacific AMS800 artificial urinary sphincter consensus statement

et al. 2022

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This Asia-Pacific (AP) AMS 800 TM artificial urinary sphincter (AUS) consensus statement aims to provide a set of practical recommendations to assist surgeons with the AMS 800 device surgery. The AP consensus committee consisted of key opinion leaders with extensive experience with AMS 800 surgery across several AP countries. The panel reviewed and discussed relevant findings with emphasis on locoregional and specific clinical challenges relevant to the AP region. Recommendations were made in key areas namely (1) patient selection and informed consent process; (2) preoperative assessment; (3) dealing with co-existing urological disorders; (4) surgical principles and intraoperative troubleshooting; (5) postoperative care; (6) special populations; and (7) cost analysis and comparative review. The AMS 800 device should be offered to males with moderate to severe stress urinary incontinence (SUI). Full informed consent should be undertaken, and emphasis is placed on surgical contraindications and high-risk candidates. The presence of a surgical mentor or referral to experts is recommended in complex AUS candidates. Preoperative cystoscopy with or without multichannel urodynamic study is necessary and patients with pre-existing urological disorders should be treated adequately and clinically stable before surgery. Adherence to strict patient selection and safe surgical principles are critical to ensure excellent clinical outcomes and minimize complications. Given that InhibiZone-coated device is not available in many AP countries, the use of prophylactic antibiotics pre-and post-operatively are recommended. The AMS 800 device should be prepared according to the manufacturer's guidelines and remains a cost-effective treatment for male SUI. The AMS 800 device remains the surgical benchmark for male SUI but is associated with certain mechanical limitations and a unique set of complications.

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Overactive bladder and urgency urinary incontinence in men undergoing artificial urinary sphincter placement

Cited by 11 publications

References 8 publications

Impact of Radiation Therapy on Outcomes of Artificial Urinary Sphincter: A Systematic Review and Meta-Analysis

Impact of Radiation Therapy on Outcomes of Artificial Urinary Sphincter: A Systematic Review and Meta-Analysis

Longitudinal deterioration in lower urinary tract symptoms after artificial urinary sphincter implantation in patients with a history of pelvic radiation therapy

The Asia‐Pacific AMS800 artificial urinary sphincter consensus statement

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