Functional outcomes of artificial urinary sphincter implantation with distal bulbar double cuff in men with and without a history of external beam radiotherapy: an analysis of a prospective database

Abstract

V.M. and P.M. contributed equally to this work. ConclusionOur data from a large institutional series indicate DC-AUS implantation to be an effective and safe treatment strategy in men with SUI and a history of RT.Keywords artificial urinary sphincter, stress urinary incontinence, pelvic radiotherapy, reconstructive urology, AMS 800 TM

Impact of Radiation Therapy on Outcomes of Artificial Urinary Sphincter: A Systematic Review and Meta-Analysis

“…The results of the search strategy and the number of records at each stage are presented in Figure 1. A total of 18 studies met the inclusion criteria and were reviewed in our study (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30). Details of the included studies are presented in Table 1.…”

“…The majority of the studies were from the USA. Two ( 18 , 23 ) were from the UK, two ( 15 , 21 ) from Germany, one ( 29 ) from Australia, and one ( 28 ) from France. All were prospective or retrospective cohort studies.…”

“…Ten studies ( 14 , 16 , 17 , 20 , 21 , 25 , 26 , 28 – 30 ) with 472 participants in the RT group and 766 participants in the no-RT group reported data on erosions. The meta-analysis demonstrated that patients with RT have a significantly increased risk of erosions (OR: 2.00 95% CI: 1.15, 3.45 I 2 = 21% p = 0.01) ( Figure 5 ).…”

“…Data on explanation and urethral atrophy was reported by only three ( 21 , 27 , 28 ) and five studies ( 14 , 20 , 23 , 25 , 26 ) respectively. Meta-analysis revealed a statistically significant increased risk of explantation in patients with RT (OR: 3.00 95% CI: 1.16, 7.75 I 2 = 68% p = 0.02) ( Figure 6 ), but there was no difference in the risk of urethral atrophy between the two groups (OR: 1.18 95% CI: 0.47, 2.94 I 2 = 46% p = 0.72) ( Figure 7 ).…”

“…Six studies ( 20 , 21 , 23 , 25 , 26 , 28 ) reported data on rates of mechanical failure. Comparing 284 patients in the RT group with 505 in the no-RT group, we found no difference in the risk of mechanical failure between the two groups (OR: 0.90 95% CI: 0.25, 3.27 I 2 = 54% p = 0.87) ( Figure 8 ).…”