A comparison of the functional durability of the AMS 800 artificial urinary sphincter between cases with and without an underlying neurogenic aetiology

Murphy, S. M.; Rea, David; O'mahony, J.; McDermott, Thomas E.; Thornhill, John; Butler, Michael R.; Grainger, Ronald G.

doi:10.1007/bf02914499

Cited by 36 publications

(25 citation statements)

References 9 publications

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“…In a retrospective comparative study, patients in the neurogenic group had a higher risk of non-mechanical device failure and requirement for reoperation compared to patients with non-neurogenic stress urinary incontinence. 10 Patki reported a 77% success rate; only 44.5% did not undergo either revision or explantation. 3 In summary, high shortterm and long-term continence rates can be achieved, but the complication and revision rates are substantial.…”

Section: Discussionmentioning

confidence: 99%

Clinical usefulness of the transobturator sub-urethral tape in the treatment of stress urinary incontinence in female patients with spinal cord lesion

Pannek

Bartel

Göcking

2012

The Journal of Spinal Cord Medicine

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Objectives: To evaluate the clinical usefulness of transobturator sub-urethral tapes for the treatment of stress urinary incontinence in women with spinal cord injury. Method and subjects: Chart review for all female patients with spinal cord injury who underwent implantation of a transobturator sub-urethral tape for treatment of stress urinary incontinence at our institution. Results: Nine women, median age 45.1 years, received a sub-urethral transobturator tape in the period November 2007 to September 2010. Four patients had paraplegia and five had tetraplegia. Seven women performed intermittent catheterization. At follow up, three of the nine patients were either cured or vastly improved. One major late complication (urethral erosion) occurred. Five of the six patients without treatment success underwent second-line treatment (artificial sphincter or urinary diversion). Conclusion: In our case series, implantation of transobturator sub-urethral tapes in women with stress urinary continence due to intrinsic sphincter deficiency and a low leak point pressure led to unfavorable results.

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Section: Discussionmentioning

confidence: 99%

Clinical usefulness of the transobturator sub-urethral tape in the treatment of stress urinary incontinence in female patients with spinal cord lesion

Pannek

Bartel

Göcking

2012

The Journal of Spinal Cord Medicine

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“…In contrast, a comparison of AUS implantation for neurogenic and non-neurogenic incontinence did not indicate a favorable outcome for the neurogenic group 120. The authors used the AMS 800™ AUS in 38 patients and followed them for a mean of 6 years.…”

Section: Surgery To Promote Urine Storagementioning

confidence: 98%

Neurogenic bladder in spinal cord injury patients

Taweel

Seyam

2015

RRU

167

182

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Neurogenic bladder dysfunction due to spinal cord injury poses a significant threat to the well-being of patients. Incontinence, renal impairment, urinary tract infection, stones, and poor quality of life are some complications of this condition. The majority of patients will require management to ensure low pressure reservoir function of the bladder, complete emptying, and dryness. Management typically begins with anticholinergic medications and clean intermittent catheterization. Patients who fail this treatment because of inefficacy or intolerability are candidates for a spectrum of more invasive procedures. Endoscopic managements to relieve the bladder outlet resistance include sphincterotomy, botulinum toxin injection, and stent insertion. In contrast, patients with incompetent sphincters are candidates for transobturator tape insertion, sling surgery, or artificial sphincter implantation. Coordinated bladder emptying is possible with neuromodulation in selected patients. Bladder augmentation, usually with an intestinal segment, and urinary diversion are the last resort. Tissue engineering is promising in experimental settings; however, its role in clinical bladder management is still evolving. In this review, we summarize the current literature pertaining to the pathology and management of neurogenic bladder dysfunction in patients with spinal cord injury.

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“…20 Neurogenic incontinence patients have statistically higher rate of nonmechanical failure than non-neurogenic group leading to higher reoperation rates. 21 In our series even though the number of patients is small, the follow-up is for a mean period of 70.2 months with the longest being 133 months. Our mechanical failures and revision rates are not so Long-term efficacy of AMS 800 AUS in male patients P Patki et al dissimilar to the published literature on AUS use in nonneurogenic incontinence.…”

Section: Discussionmentioning

confidence: 73%

Long-term efficacy of AMS 800 artificial urinary sphincter in male patients with urodynamic stress incontinence due to spinal cord lesion

Patki¹,

Hamid²,

Shah³

et al. 2005

Spinal Cord

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Study design: Retrospective analysis. Objectives: To evaluate long-term efficacy and complications of AMS 800 (American Medical Systems s ) artificial urinary sphincter (AUS) in treatment of urodynamic stress incontinence (USI) in male patients with spinal cord lesion (SCL). Setting: London Spinal Injuries Unit, Stanmore, UK and Institute of Urology and Nephrology, London, UK. Patients and methods: A retrospective analysis identified nine males with SCL (five thoracic, three lumbar, one cervical) with USI, who underwent AMS 800 AUS implantation by a single surgeon at a specialist spinal injuries unit. The mean age was 38.2 years (range 27-47 years), with the mean time since injury of 13.8 years (range 6-26 years). In all, seven were complete and two were incomplete SCL (traumatic spinal injury eight, tranverse myelitis one). All implants were inserted with the urethral cuff around the bulbar urethra with a 61-70 cm water pressure reservoir in the retropubic space. Implant activation was carried out at 6 weeks postoperatively. All patients were regularly followed up in outpatient clinics at the interval of 3 months, 6 months and yearly thereafter. An ultrasound examination for the upper tracts and a videocystometrogram (VCMG) was carried out at 3 months postsurgery and then yearly. Results: The follow-up ranged from 3 to 133 months (mean 70.2 months). All implants were activated successfully with no intra-or immediate-postoperative complications. At activation all patients reported total urinary continence with seven out of nine implants (77%) currently working well. Two patients reported significant recurrent incontinence at 3 month follow-up, one of whom underwent a removal of the entire implant at the end of 3 months and the other was continent after a pump and cuff revision. The implant removed at 3 months was due to erosion and infection while the second was removed at 24 months due to secondary implant infection. Three out of seven (43%) successful implants required one revision each. One patient continues to report minimal leakage only during transfers with no leak demonstrated on postoperative VCMG. One patient with indwelling urethral catheter, two with suprapubic catheter and one voiding on urge have changed their bladder management to intermittent catheterisations postoperatively. All removals and revision procedures were carried out in the first 53 months of follow-up and four out of seven implants (57%) required no revisions. Conclusion: On a long term, AMS 800 is a viable option to treat USI in men with SCL. Mechanical revisions are frequent but effective. Strict patient selection, optimum preoperative bladder management and regular follow-up ensure low complication and high efficacy rates in the long term.

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A comparison of the functional durability of the AMS 800 artificial urinary sphincter between cases with and without an underlying neurogenic aetiology

Cited by 36 publications

References 9 publications

Clinical usefulness of the transobturator sub-urethral tape in the treatment of stress urinary incontinence in female patients with spinal cord lesion

Clinical usefulness of the transobturator sub-urethral tape in the treatment of stress urinary incontinence in female patients with spinal cord lesion

Neurogenic bladder in spinal cord injury patients

Long-term efficacy of AMS 800 artificial urinary sphincter in male patients with urodynamic stress incontinence due to spinal cord lesion

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