Laparoscopic implantation of artificial urinary sphincter in women with intrinsic sphincter deficiency: Mid‐term outcomes

Ferreira, Carlos Noronha; Brychaert, Pierre-Emannuel; Menard, J.; Mandron, E.

doi:10.1111/iju.13296

Cited by 22 publications

(18 citation statements)

References 21 publications

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“…The aim of the present study was to update and analyse the safety and outcomes of laparoscopic AUS implantation in women with SUI caused by ISD in our 13‐year single‐centre experience.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic artificial urinary sphincter implantation in women with stress urinary incontinence: update on 13 years’ experience in a single centre

Bracchitta

Costa

Borojeni³

et al. 2019

BJU International

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Objectives To update the outcomes and analyse the safety of laparoscopic implantation of an artificial urinary sphincter (AUS) in women with stress urinary incontinence (SUI) as a result of intrinsic sphincter deficiency (ISD). Patients and Methods Seventy‐four women with SUI caused by ISD underwent laparoscopic AUS implantation between 2005 and 2018 in our centre. Urodynamic assessment was required. The AUS was implanted using a transperitoneal laparoscopic approach to the Retzius space. The cuff was placed around the bladder neck between the peri‐urethral fascia and the vagina. Postoperative functional outcomes were defined as success (total continence), improvement (>50% decrease in number of leakages or in number of pads used), or failure (<50% improvement, persistent or increased leaking). Data on peri‐operative and long‐term complications were also collected. Results The mean ± sd operating time was 119.7 ± 48.9 min, with no conversion to laparotomy. With a mean ± sd (range) follow‐up of 44.5 ± 40.5 (1–149) months, 78.3% of the women were totally continent and 18.6% reported improvement. One vaginal and one urethral perforation were the only intra‐operative complications, both solved during surgery. Late complications included recurrent urinary tract infection (5.4%), acute urinary retention (6.8%), urethral (4%) and vaginal erosion (2.7%), and urgency urinary incontinence (2.7%). Reimplantation of AUS was performed in 13.5% of the women as a result of mechanical failure (n =9) and erosion (n = 1). Permanent removal was performed in 10.8%. Conclusion To our knowledge, this is the largest series with the longest follow‐up of women with urinary incontinence treated with laparoscopic AUS implantation, demonstrating its safety, feasibility and effectiveness, and showing a very positive impact on the quality of life of the women.

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Section: Introductionmentioning

confidence: 99%

Laparoscopic artificial urinary sphincter implantation in women with stress urinary incontinence: update on 13 years’ experience in a single centre

Bracchitta

Costa

Borojeni³

et al. 2019

BJU International

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show abstract

“…Likewise, the surgical approach may have a significant impact on outcomes, as suggested by the promising results of most laparoscopic and robotic series . Indeed, while those studies assessed the early learning curve of this new technique, they reported outcomes similar to many large open series.…”

Section: Discussionmentioning

confidence: 99%

“…Data on the subsequent management of women who experienced device explantation for erosion or infection were too sparse to be analyzed accurately for the purpose of this systematic review. In the few series describing the management of these patients, three options were reported: ileal conduit, repeat implantation, and status quo . While the feasibility of AUS reimplantation has been demonstrated by several series in male patients, more robust data are needed regarding the outcomes of subsequent anti‐incontinence procedures after explantation in female patients.…”

Section: Discussionmentioning

confidence: 99%

“…The proportion of patients with a history of pelvic radiation therapy was small, ranging from 0% to 5.9%. One study reported on the vaginal approach, 11 on the open approach, two on the laparoscopic approach, and three on the robot‐assisted approach (one study compared the open and robot‐assisted approaches and each group was analyzed separately for the purpose of the present systematic review).…”

Section: Evidence Synthesismentioning

confidence: 99%

“…The 17 included studies were single-center prospective or retrospective series [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] and are summarized in Table 1. No randomized or properly designed prospective cohort studies were found.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

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AMS‐800 Artificial urinary sphincter in female patients with stress urinary incontinence: A systematic review

Peyronnet¹,

O’Connor²,

Khavari³

et al. 2018

Neurourology and Urodynamics

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Aims To perform a systematic review of studies reporting the outcomes of AMS‐800 artificial urinary sphincter (AUS) implantation in female patients with stress urinary incontinence (SUI) resulting from intrinsic sphincter deficiency (ISD). Methods A systematic literature search of the Medline and Embase databases was performed in June 2018 in accordance with the PRISMA statement. No time limit was used. The protocol was registered in PROSPERO (CRD42018099612). Study selection and data extraction were performed by two independent reviewers. Results Of 886 records screened, 17 were included. All were retrospective or prospective non‐comparative case series. One study reported on vaginal AUS implantation, 11 on open AUS implantation, two on laparoscopic AUS implantation, two on robot‐assisted AUS implantation and one compared open and robot‐assisted implantations. The vast majority of patients had undergone at least one anti‐incontinence surgical procedure prior to AUS implantation (69.1‐100%). The intraoperative bladder neck injury rates ranged from 0% to 43.8% and the intraoperative vaginal injury rates ranged from 0 to 25%. After mean follow‐up periods ranging from 5 to 204 months, the complete continence rates ranged from 61.1% to 100%. The rates of explantation, erosion and mechanical failure varied from 0% to 45.3%, 0% to 22.2% and 0% to 44.1%, respectively. Conclusions AMS‐800 AUS can provide excellent functional outcomes in female patients with SUI resulting from ISD but at the cost of a relatively high morbidity. High level of evidence studies are needed to help better define the role of AUS in the female SUI armamentarium.

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Treatments for Lower Urinary Tract Dysfunction

Yeo¹,

Hashim²

2021

Abrams’ Urodynamics

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Laparoscopic implantation of artificial urinary sphincter in women with intrinsic sphincter deficiency: Mid‐term outcomes

Abstract: Herein we report one of the largest series with the longest follow up evaluating the outcomes of laparoscopic artificial urinary sphincter implantation in female patients. This approach seems to be a safe and effective treatment option for patients with intrinsic sphincter deficiency.

Cited by 22 publications

References 21 publications

Laparoscopic artificial urinary sphincter implantation in women with stress urinary incontinence: update on 13 years’ experience in a single centre

Laparoscopic artificial urinary sphincter implantation in women with stress urinary incontinence: update on 13 years’ experience in a single centre

AMS‐800 Artificial urinary sphincter in female patients with stress urinary incontinence: A systematic review

Treatments for Lower Urinary Tract Dysfunction

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