Long-Term Durability and Functional Outcomes Among Patients With Artificial Urinary Sphincters: A 10-Year Retrospective Review From the University of Michigan

Abstract

Long-term durability and functional outcomes are achievable for the AMS 800, but there are appreciable complication rates for erosion, mechanical failure and infection in the first 48 months from implantation.

The artificial urinary sphincter is the treatment of choice for post–radical prostatectomy incontinence

“…Most recent large series report an incidence Suburethral slings v. AUS for PPI of infection and erosion of generally less than 8%. [15][16][17][33][34][35][36][37] As would be expected, the highest incidence has been reported with the longest followup (10-15 yr). 8 Recurrent incontinence may be due to alteration in bladder function (overactivity), urethral atrophy or mechanical malfunction.…”

“…Success rates for AUS as defined by a continence status of 0 to 1 pads per day range from 59% to 90%, 6,7 as shown in Table 1. 2,6,[8][9][10][11][12][13][14][15][16][17] Just as with reported rates of incontinence following prostate cancer surgery depend on the definition of incontinence, continence rates with the AUS can vary with the definition of continence, the method of evaluation and the length of follow-up. The lowest rates are from patient-administered questionnaires.…”

Comparison of complication rates related to male urethral slings and artificial urinary sphincters for urinary incontinence: national multi-institutional analysis of ACS-NSQIP database

“…It underwent a significant improvement through the introduction of Narrow Back Cuff (NBC) AMS800® device in 1987 (American Medical Systems, Minnetonka, MN, USA) [17]. Throughout its existence, AUS has been considered the standard of care for surgical treatment for SUI, with a 5-and 10-year device survival rate of 75 and 65 %, respectively [5,[18][19][20]. In a recent meta-analysis by Van der Aa et al [5] looking at 12 reports of 623 patients with a minimum follow-up of 2 years, AUS achieved a continence rate (defined as 0-1 pad/day) of 61-100 %.…”

Stemming the tide of mild to moderate post-prostatectomy incontinence: A retrospective comparison of transobturator male slings and the artificial urinary sphincter

“…12 A review of the literature is documented in Table 3, with continence rates ranging from 59-90%. [12][13][14][15][16][17][18][19][20] To make a more meaningful comparison, only studies defining continence as requiring ≤1 pad/day were included. Sacco and colleagues demonstrated that the criterion of pad usage discriminates well between a limited reduction and markedly affected quality of life, noting that it is clinically valid to consider ≤1 pad/day as continent.…”