Contemporary surgical devices for male stress urinary incontinence: a review of technological advances in current continence surgery

Chung, Eric

doi:10.21037/tau.2017.04.12

Cited by 25 publications

(44 citation statements)

References 75 publications

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“…Complete continence without the need to use any pads has a considerable impact on the quality of life after AUS implantation [15]. Such results are obtained in 4.3-85% of patients in various reports [16,17]. However, in most cases, the rate is not higher than 50% [10].…”

Section: Discussionmentioning

confidence: 99%

Artificial urinary sphincter implantation with a periprostatic cuff placement for urinary incontinence in men

Szopiński¹,

Sudoł‐Szopińska²,

Czech³

et al. 2019

aoms

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Introduction: Artificial urinary sphincter (AUS) implantation is the treatment of choice for male urinary incontinence (UI). The aim of the present study was to evaluate treatment outcomes of UI in men using an AUS with a cuff placed around the prostatic urethra. Material and methods: Forty-three men with preserved prostatic urethra were selected for AUS implantation due to UI. Twenty patients had the cuff implanted around the prostate using the retropubic approach (Group 1), and 23 had the cuff placed around the bulbous urethra (Group 2). Both groups were compared in terms of continence quality as well as intra-and postoperative complications. Results: The groups were comparable with respect to age and duration of follow-up. Median time to complications was 90.3 and 10.7 months in Group 1 and Group 2, respectively (p = 0.007). The complication rate was 40% and 58.3% in Group 1 and 2, respectively (p = 0.001). Complete continence was obtained in 80% of patients from Group 1 and 33.3% of men from Group 2A (p = 0.001). Conclusions: The analysis indicates that cuff placement around the prostatic urethra results in better continence and is characterised by fewer complications. This method is dedicated for patients who have not had the prostate gland removed. Due to the retrospective nature of this analysis and small groups of patients, it is not possible to formulate ultimate recommendations.

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Section: Discussionmentioning

confidence: 99%

Artificial urinary sphincter implantation with a periprostatic cuff placement for urinary incontinence in men

Szopiński¹,

Sudoł‐Szopińska²,

Czech³

et al. 2019

aoms

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“…Despite the increase in alternative prosthetic devices, [10][11][12][13] AMS 800 still provides the highest long-term reference data and remains a fundamental device for surgical treatment of severe urinary incontinence. 3,4,14,15 Therefore, it is assumed as the main reference for the investigation within the present work. Cuffs were provided by Boston Scientific and represented the basis for the investigation.…”

Section: Experimental Testsmentioning

confidence: 99%

Interaction phenomena between a cuff of an artificial urinary sphincter and a urethral phantom

2019

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Male urinary incontinence is highly prevalent, leading to a miserable quality of life. The artificial urinary sphincter (AUS) is the device that closely simulates the function of the biological urinary sphincter. The precise evaluation of occlusion mechanisms and of interaction phenomena occurring between AUS cuff and urethral duct is fundamental for more reliable design. The action induced in the interaction with urethral duct under a specific pressure depends on its constitutive material and structural characteristics. The methods of experimental and computational bioengineering are exploited to investigate mechanical functionality of the coupled system, as AUS and urethral duct. Experimental tests are developed to investigate the response when the AUS is inflated around a urethral phantom. Numerical model of the cuff is developed mimicking the experimental tests for the validation. Subsequently, numerical models are exploited to interpret the interaction of the cuff with urethral phantoms considering the influence of urethral size and of tissues mechanical behavior, mimicking healthy and degraded configurations. The investigation provides useful information on the behavior of AUS cuff with urethral duct evaluating the action induced and represents a support for planning an extension of experimental tests on animal and human urethral samples.

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“…Sphincter implants, especially AUS, are designated in patients with moderate-to-severe UI not susceptible to conservative regimen, although they are expensive and have a high rate of re-do procedure [9]. MS can be split into adjustable or nonadjustable types and offer a charming choice for men who hope to keep away from mechanical acting in the time of urinary voiding [10]. Over the past 2 decades, this procedure has progressed regarding both surgical method and sling style, and numerous devices are currently usable that have diverse mechanisms of action.…”

Section: Injmentioning

confidence: 99%

“…The implant is not contraindicated in men after urethral or previous incontinence operation. Published adverse events contain wound dehiscence, perineal discomfort, urethral injury, and urinary retention [10,30].…”

Section: Atoms Sling (Ami Gmbh)mentioning

confidence: 99%

Artificial Urinary Sphincter for Postradical Prostatectomy Urinary Incontinence — Is It the Best Option?

Yoo

2019

Int Neurourol J

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Male stress urinary incontinence (SUI) can undoubtedly reduce quality of life and promote personal distress and psychosocial alienation. The frequency of postprostatectomy urinary incontinence (PPI) counts on the characterization of urinary incontinence and the periods of patient follow-up. Operational therapeutics, for instance, urethral male slings and artificial urinary sphincters, are well-chosen as adequate and secure surgeries for male SUI in men with continual PPI when conservative treatment is ineffective. Over the former 2 decades, surgery has progressed regarding both operative approach and sling architecture. However, there are no guidelines about when surgery should be carried out and which is the most appropriate surgical option. In this review, we summarize recent advances in implantable devices for PPI and also discuss traditional surgical care. When we are planning the male PPI surgery, careful preoperative work-up should be performed and surgical method should be chosen according to the severity of the disease. Male sling is preferred in mild and moderate symptomatic patients with normal detrusor pressure and it is recommended to select traditional artificial urinary sphincter device in those with severe symptoms. It is expected that effective devices without adverse events will be developed with technical advances in near future.

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Contemporary surgical devices for male stress urinary incontinence: a review of technological advances in current continence surgery

Cited by 25 publications

References 75 publications

Artificial urinary sphincter implantation with a periprostatic cuff placement for urinary incontinence in men

Artificial urinary sphincter implantation with a periprostatic cuff placement for urinary incontinence in men

Interaction phenomena between a cuff of an artificial urinary sphincter and a urethral phantom

Artificial Urinary Sphincter for Postradical Prostatectomy Urinary Incontinence — Is It the Best Option?

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