Men with BPH-related lower urinary tract symptoms and chronic prostatic inflammation should be considered at increased risk of symptom progression and acute urinary retention during follow-up. Although preclinical studies provide a biological rationale for the relationship between inflammation and the risk of PCa, clinical investigations report conflicting results and the direct relationship between inflammation and malignant transformation in the human prostate is still debated.
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.
This population-based study provides the first evidence of improved CSM free survival and OM free survival in patients with de novo mPCa since the introduction of several systemic agents for CRPC patients.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.