Primary and revision artificial urinary sphincter for stress urinary incontinence post-radical prostatectomy: a surgery with high rewards but high risks?

被引:0
作者
Roth, Ingunn [1 ,2 ]
Hjelle, Karin Margrethe [1 ,2 ]
Johansen, Charlotte Josefine [2 ]
Moen, Christian Arvei [1 ,2 ]
Beisland, Christian [1 ,2 ]
Julieo-Jone, Patric [1 ,2 ]
机构
[1] Haukeland Hosp, Dept Urol, Bergen, Norway
[2] Univ Bergen, Dept Clin Med, Bergen, Norway
关键词
Artificial urinary sphincter; Stress urinary incontinence; Prostheses and Implants; Surgical outcomes; Prostate cancer; OUTCOMES; REGRET; IMPACT; MEN;
D O I
10.2340/sju.v59.42340
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Objectives: To evaluate the efficacy of artificial urinary sphincter (AUS) implantation in men with stress urinary incontinence post-radical prostatectomy and the complication burden with a focus on identifying potential risk factors for reoperation as well as determining the fate of revision surgeries. Methods: Retrospective analysis of consecutive patients undergoing primary AUS (pAUS) and revision AUS (rAUS) implantation at a tertiary centre. Logistic regression was employed to identify risk factors for reoperation associated with non-mechanical failures. Kaplan Meier method was applied to generate implant patency curves. Results: Over 11-years, 108 and 28 patients underwent pAUS and rAUS, respectively. Amongst the former group, a 30-day complication rate of 20.4% was found with a complete (zero pad) dryness rate at follow-up of 49.1%. Post-operative infection was the commonest occurring complication in 7.4%. After pAUS, 27.8% underwent reoperation with cuff erosion being the top indication in 46.7%. Diabetes was a significant predictor for reoperation with an associated 3.6-fold increased risk. The 3-year and 5-year device survival rates without reoperation for pAUS were 80% and 76%, respectively. For rAUS, complete dryness rates achieved were lower at 32.1%. The rate of reoperation was higher at 42.9% with a significantly worse survival probability compared to pAUS (p = 0.024). Conclusions: Whilst men may achieve complete dryness after pAUS, the potential complication burden and risk of reoperation are not low, and patients need to be counselled regarding this. Chances of continence success are lower when revision surgery is performed with a worse implant survival probability.
引用
收藏
页码:185 / 189
页数:5
相关论文
共 24 条
  • [1] Ameli G, 2023, Continence Rep, V6, DOI [10.1016/j.contre.2023.100028, DOI 10.1016/J.CONTRE.2023.100028]
  • [2] Primary implantation of an artificial urinary sphincter using the perineal and penoscrotal approaches: Functional results and assessment of reoperative procedures
    Bernard, Clemence
    Bentellis, Imad
    El-Akri, Mehdi
    Durand, Matthieu
    Guerin, Olivier
    Cornu, Jean -Nicolas
    Cousin, Tiffany
    Gaillard, Victor
    Dupuis, Hugo
    Tricard, Thibault
    Hermieu, Nicolas
    Lecoanet, Pierre
    Bruyere, Franck
    Capon, Gregoire
    Biardeau, Xavier
    Karam, Elias
    Saussine, Christian
    Hermieu, Jean-Francois
    Peyronnet, Benoit
    Game, Xavier
    Brierre, Thibaut
    [J]. FRENCH JOURNAL OF UROLOGY, 2024, 34 (03):
  • [3] Post-prostatectomy incontinence: a guideline of guidelines
    Bhatt, Nikita R.
    Pavithran, Aswathy
    Ilie, Cristian
    Smith, Lee
    Doherty, Ruth
    [J]. BJU INTERNATIONAL, 2024, 133 (05) : 513 - 523
  • [4] Montreal electronic artificial urinary sphincters: Our futuristic alternatives to the AMS800™
    Biardeau, Xavier
    Hached, Sami
    Loutochin, Oleg
    Campeau, Lysanne
    Sawan, Mohamad
    Corcos, Jacques
    [J]. CUAJ-CANADIAN UROLOGICAL ASSOCIATION JOURNAL, 2017, 11 (10): : E396 - E404
  • [5] Artificial urinary sphincter
    Brant, William O.
    Martins, Francisco E.
    [J]. TRANSLATIONAL ANDROLOGY AND UROLOGY, 2017, 6 (04) : 682 - 694
  • [6] Surgical treatment for urinary incontinence after prostatectomy: A meta-analysis and systematic review
    Chen, Yu-Chi
    Lin, Pin-Hsuan
    Jou, Yann-Yuh
    Lin, Victor Chia-Hsiang
    [J]. PLOS ONE, 2017, 12 (05):
  • [7] Application of the decisional regret scale (DRS) in men undergoing anti-incontinence procedures for stress urinary incontinence
    Dunbar, Alayna
    Heinlen, Jonathan
    Slobodov, Gennady
    Meenakshi-Sundaram, Bhalaajee
    Furr, James
    [J]. TRANSLATIONAL ANDROLOGY AND UROLOGY, 2023, 12 (09) : 1408 - 1415
  • [8] Gravas S., 2019, EAU Guidelines on management of non-neurogenic male LUTS including benign prostatic obstruction
  • [9] Predictors of Regret among Older Men after Stress Urinary Incontinence Treatment Decisions
    Hampson, Lindsay A.
    Suskind, Anne M.
    Breyer, Benjamin N.
    Cooperberg, Matthew R.
    Sudore, Rebecca L.
    Keyhani, Salomeh
    Allen, I. Elaine
    Walter, Louise C.
    [J]. JOURNAL OF UROLOGY, 2022, 207 (04) : 885 - 892
  • [10] Hoyland Kimberley, 2014, Rev Urol, V16, P181