Erosion Rate of the Double Cuff AMS800 Artificial Urinary Sphincter: Long-Term Followup

Kowalczyk, John J.; Spicer, Donald; Mulcahy, John J.

doi:10.1016/s0022-5347(01)65573-3

Cited by 38 publications

(13 citation statements)

References 7 publications

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“…Although initial success rates after tandem cuff placement were reported to be up to 95%, there was concern that this technique could lead to an increased rate of erosion. However, a study published examining long‐term erosion rates after tandem cuff placement in 95 patients with a mean follow up of 28 months found an overall erosion rate of 10.5%, which is within the range reported for single‐cuff systems . A retrospective review comparing single and tandem cuff placement in 56 patients with the same degree of incontinence (>5 pads daily) found a significantly higher rate of complete continence (no pad use) and improvement in the Incontinence Impact Questionnaire – short form (IIQ‐7) scores in patients who received the tandem cuff.…”

Section: Revisionsmentioning

confidence: 79%

“…However, a study published examining long-term erosion rates after tandem cuff placement in 95 patients with a mean follow up of 28 months found an overall erosion rate of 10.5%, which is within the range reported for single-cuff systems. 28 A retrospective review comparing single and tandem cuff placement in 56 patients with the same degree of incontinence (>5 pads daily) found a significantly higher rate of complete continence (no pad use) and improvement in the Incontinence Impact Questionnaire -short form (IIQ-7) scores in patients who received the tandem cuff. The complication rates were similar; however, this should be taken with caution given that the follow up for the single cuff patients was significantly longer than for the tandem cuff group (41 vs 21 months).…”

Section: Mechanical Dysfunctionmentioning

confidence: 99%

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Artificial urinary sphincter for post‐prostatectomy incontinence: A review

James

McCammon

2014

Int J of Urology

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Abstract:The artificial urinary sphincter remains the gold standard for treatment of postprostatectomy urinary incontinence. The AMS 800 (American Medical Systems, Minnetonka, MN, USA) is the most commonly implanted artificial urinary sphincter. Having been on the market for almost 40 years, there is an abundance of literature regarding its use, but no recent review has been published. We reviewed the current literature regarding the indications, surgical principles, outcomes and complications of artificial urinary sphincter implantation for stress urinary incontinence after prostatectomy. A PubMed search was carried out for articles on the artificial urinary sphincter from 1995 to present. The review was centered on articles related to the use of the AMS 800 for stress urinary incontinence in males after prostatectomy. Relevant articles were reviewed. The majority of patients will achieve social continence (1 pad per day) after artificial urinary sphincter implantation; however, rates of total continence (no pad usage) are significantly lower. Patient satisfaction outcomes average greater than 80% in most series. Potential complications requiring reoperation include infection (0.5-10.6%) and urethral erosion (2.9-12%). Revision surgeries are most commonly as a result of urethral atrophy, which ranges from 1.6 to 11.4%. The 5-year Kaplan-Meier freedom from reoperation ranges from 50 to 79%, while the 10-year Kaplan-Meier freedom from mechanical failure is 64%. The artificial urinary sphincter is a reliable device with good outcomes. As expected with any prosthetic device, complications including mechanical failure, infection, erosion and recurrent incontinence remain significant concerns. Despite known complications, the patient satisfaction rates after artificial urinary sphincter implantation remain high. Appropriate patient counseling and adherence to surgical principles are imperative.

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Section: Revisionsmentioning

confidence: 79%

Section: Mechanical Dysfunctionmentioning

confidence: 99%

Artificial urinary sphincter for post‐prostatectomy incontinence: A review

James

McCammon

2014

Int J of Urology

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“…The urethral atrophy occurs by the decrease in the diameter of the urethra, leading to the insidious return of urinary incontinence. Erosion results in the migration of a component of anti-incontinence device into urethral lumen (8, 9) which is clinically expressed by perineal discomfort, vaginal discharge, hematuria, dysuria and urinary infection (10). …”

Section: Introductionmentioning

confidence: 99%

A new material to prevent urethral damage after implantation of artificial devices: an experimental study

et al. 2017

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Objective To validate the application of the bacterial cellulose (BC) membrane as a protecting barrier to the urethra.Materials and Methods Forty female Wistar rats (four groups of 10): Group 1 (sham), the urethra was dissected as in previous groups and nothing applied around; Group 2, received a 0.7cm strip of the BC applied around the urethra just below the bladder neck; Group 3, received a silicon strip with the same dimensions as in group 2; Group 4, had a combination of 2 and 3 groups being the silicon strip applied over the cellulosic material. Half of the animals in each group were killed at 4 and 8 months. Bladder and urethra were fixed in formalin for histological analysis.Results Inflammatory infiltrates were more intense at 4 months at lymphonodes (80% Grade 2), statistically different in the group 2 compared with groups 1 (p=0.0044) and 3 (p=0.0154). At 8 months, all samples were classified as grade 1 indicating a less intense inflammatory reaction in all groups. In group 2, at 8 months, there was a reduction in epithelial thickness (30±1μm) when com-pared to groups 1 (p=0.0001) and 3 (p<0.0001). Angiogenesis was present in groups 2 and 4 and absent in group 3. In BC implant, at 4 and 8 months, it was significant when comparing groups 4 with 1 (p=0.0159).Conclusion BC membrane was well integrated to the urethral wall promoting tissue remodeling and strengthening based on morphometric and histological results and may be a future option to prevent urethral damage.

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“…Despite this, the fact that the AUS is a foreign body has led to complications such as erosion of the bladder neck and/or infection. 2,[5][6][7][8][9] Another problem with the AUS is the fact that the tension it exerts around the urethra can only be adjusted at the time it is surgically implanted and not thereafter. If the patient starts to leak or has an urethral obstruction, an additional surgical procedure is needed to adjust the AUS pressure.…”

mentioning

confidence: 99%

Gracilis muscle neosphincter for treating urinary incontinence

et al. 2001

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The purpose of this study was to test the anatomical and functional feasibility of using a gracilis muscle free flap to create a urinary sphincter. Anatomical studies were performed in 12 human cadavers and short-term (n = 7) and long-term (n = 8) functional studies were performed in dogs. In the short-term functional studies, the left gracilis muscle was transferred into the pelvis and wrapped around the urethra and the right gracilis muscle was wrapped around a stent. A cuff electrode was placed on the muscle's nerve pedicle and used to stimulate the neosphincter while peak pressure, fatigue rate, and perfusion measurements were performed. In the long-term functional studies, intramuscular electrodes were inserted into the neosphincter to stimulate the flap. The flaps were wrapped around the urethra and dogs were followed for 16 weeks, during which time urodynamic measurements were performed. Our anatomical studies demonstrated that the gracilis muscle free flap could be transferred into the pelvis to create a urinary neosphincter. Our short-term functional study demonstrated that gracilis muscle free-flap function and perfusion were not compromised by transfer. In our long-term functional study, all neosphincters provided bladder outlet resistance pressures consistent with continence. Our anatomical, short-term, and long-term functional studies indicate that a gracilis muscle free-flap neosphincter is an effective procedure for treating urinary incontinence.

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Erosion Rate of the Double Cuff AMS800 Artificial Urinary Sphincter: Long-Term Followup

Abstract: Addition of a second cuff to the artificial urinary sphincter remains a safe alternative for patients with severe urinary stress incontinence.

Cited by 38 publications

References 7 publications

Artificial urinary sphincter for post‐prostatectomy incontinence: A review

Artificial urinary sphincter for post‐prostatectomy incontinence: A review

A new material to prevent urethral damage after implantation of artificial devices: an experimental study

Gracilis muscle neosphincter for treating urinary incontinence

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