Intermediate outcomes after transcorporal placement of an artificial urinary sphincter

Abstract

Abbreviations & AcronymsResults: Eight patients each underwent primary transcorporal cuff placement and revision surgery. Complete data for analysis were available in 15 patients at a median follow up of 45 months (range 23-91 months). The success rate (defined as use of 0-1 pads per day) was 80% (12/15 patients). Average voiding score was 2/20 (standard deviation 1.88), average irritative score was 3/24 (standard deviation 4.92) and the mean Quality-of-Life score was 0.66 (standard deviation 1.04). Conclusions: Transcorporal placement of an artificial urinary sphincter is both safe and efficacious in patients with a small caliber or atrophic urethra, either as a primary or salvage procedure. Efficacy and level of satisfaction in this subset of patients is equivalent to those undergoing traditional artificial urinary sphincter cuff placement.

Complications following artificial urinary sphincter placement after radical prostatectomy and radiotherapy: a meta‐analysis

“…The mean ( sd ) percentage of surgical revisions across all studies in RP + EBRT patients was 37.3 ± 6.1% (95% CI 23.4–51.1), whereas the risk of surgical revision in non‐irradiated men was 19.8 ± 3.6% (95% CI 11.9–27.6; P < 0.007, n = 15 studies), giving a pooled random‐effects RR of 1.56 (95% CI 1.02–2.41; P < 0.005), (Table , Fig. A) and a pooled random‐effects risk difference of 16.0% (95% CI 2.05–36.01; P < 0.080) (Table ; Fig. B) .…”

“…The AMS800 ™ device is referred to as the AUS in this manuscript. Although positive continence outcomes are reported after AUS implantation for post‐RP UI, the reported rate of surgical revision varies widely, ranging from 5.0% to 40.0% , and published rates of persistent UI after AUS implantation in irradiated men ranges from 5.0% to 48.0% .…”

“…Typically, 30.0–40.0% of men receiving the AUS device for post‐RP UI have also undergone external beam radiotherapy (EBRT) . Pelvic irradiation is considered a substantial risk factor to the longevity and outcomes of the AUS device .…”

Risk Factors for Erosion of Artificial Urinary Sphincters: A Multicenter Prospective Study

“…Other TC studies have shown the technique to be especially effective and safe in the severely compromised urethra, including those with prior radiation, urethral reconstruction, and rectourethral fistula repairs. 13,14 Concerns with the TC technique have been raised, however, including the potential for postoperative erectile dysfunction and higher rates of postoperative urinary retention. 15 …”

Artificial sphincter

“…Therefore, the transcorporal implantation of a single or double cuff system has been reported in the past. Current literature corroborates this approach in small patient cohorts as an effective option in primary and salvage situations with either single or tandem cuff use where social continence rates have been reported up to 70-80% [52][53][54].…”