13 Years of Experience With Artificial Urinary Sphincter Implantation at Baylor College of Medicine

Abstract

An artificial urinary sphincter is durable treatment for sphincter deficiency even in patients with a history of complications, neurogenic bladder, pelvic radiation, bladder neck contracture, Valsalva voiding, or failed injectables or slings.

Outcomes related to placing an artificial urinary sphincter using a single‐incision, transverse‐scrotal technique in high‐risk patients

“…In the present study, revision was required in 37.5% of irradiated and 8.5% of unirradiated patients; the respective reported rates of revision in modern series was 20-64% [8,[10][11][12] and 15.8-38.5% [8,11,12]. The total explantation/ revision rate for all patients in the present series was 16.8%, which is also comparable to similar studies in which the overall revision rate was 27.1% [12].…”

“…In the present series, 2% of unirradiated and 17% of irradiated patients required revision for urethral atrophy, compared with previous reports of 14-20% of irradiated [9-11] and 3.5-14% of unirradiated patients [11,12]. In the present series, 85% of unirradiated and 79% of irradiated patients used one or fewer pads for urinary leakage after AUS implantation.…”

“…Furthermore, these queries have not been clarified in high-risk patients. Several investigators have reviewed the outcomes after placing AUS in high-risk patients, including those who have had RT; all of these studies primarily used a perineal, two-incision approach for placing the AUS [7][8][9][10][11][12].…”

Comparison of complication rates related to male urethral slings and artificial urinary sphincters for urinary incontinence: national multi-institutional analysis of ACS-NSQIP database

“…It underwent a significant improvement through the introduction of Narrow Back Cuff (NBC) AMS800® device in 1987 (American Medical Systems, Minnetonka, MN, USA) [17]. Throughout its existence, AUS has been considered the standard of care for surgical treatment for SUI, with a 5-and 10-year device survival rate of 75 and 65 %, respectively [5,[18][19][20]. In a recent meta-analysis by Van der Aa et al [5] looking at 12 reports of 623 patients with a minimum follow-up of 2 years, AUS achieved a continence rate (defined as 0-1 pad/day) of 61-100 %.…”

421 the Surgical Learning Curve for Artificial Urinary Sphincter Procedures Compared to Typical Surgeon Experience

“…Early reoperations are usually due to infection, recurrent incontinence, or urethral erosion 14,15 , all of which are likely affected by surgical technique. Another cause for reoperation is device failure.…”