Performance and Safety of the Artificial Urinary Sphincter (AMS 800) for Non-neurogenic Women with Urinary Incontinence Secondary to Intrinsic Sphincter Deficiency: A Systematic Review

Reus, Christine; Phé, Véronique; Dechartres, Agnès; Grilo, Nuno; Chartier‐Kastler, Emmanuel; Mozer, Pierre

doi:10.1016/j.euf.2018.10.009

Cited by 30 publications

(18 citation statements)

References 33 publications

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“…Functional long-term results after AUS implantation have previously been reported to be acceptable. In the systematic review published by Reus and colleagues in 2018, evaluating the safety and effectiveness of AUS in non-neurogenic women, 1 the complete continence rates, defined as ‘no pad’, were reported to range from 42% to 86% across studies using the open technique. In female neurological patients with SUI, AUS has a complete continence rate of 71.4%.…”

Section: Discussionmentioning

confidence: 99%

“…5 The heterogeneity of the complete continence rate may be explained by follow up variability between the studies, ranging from 17 to 204 months in the review of Reus and colleagues. 1 Phé and colleagues demonstrated that a short follow up was not sufficient to assess the occurrence of serious side-effects. 5 Our study includes the longest follow up with a median of 15 years.…”

Section: Discussionmentioning

confidence: 99%

“…Artificial urinary sphincter (AUS) in female patients is known to give good rates of satisfaction and functional outcome (continence estimated between 42% and 86%), 1 but is not widely used due to operative difficulties. AUS implantation is extremely challenging, especially after multiple anti-incontinence surgeries, and patient selection can also be difficult.…”

Section: Introductionmentioning

confidence: 99%

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Outcomes of open artificial urinary sphincter in women with stress urinary incontinence: long-term follow up

Tricard

Jochum

Bergerat

et al. 2019

Therapeutic Advances in Urology

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Background: The aim of this study was to report the outcomes of artificial urinary sphincter (AUS) in women with stress urinary incontinence (SUI) resulting from intrinsic sphincter deficiency after a follow up of 10 years. Methods: The charts of female patients with moderate-to-severe SUI who underwent open AUS implantation between November 1994 and April 2007 were reviewed retrospectively. All patients were operated on by a single experienced surgeon through an open retropubic approach with systematic bladder incision. Primary endpoint was postoperative continence categorized as complete continence (no pads used), improved incontinence, or unchanged incontinence. Results: A total of 63 women (mean age: 58 years, range: 17–82) underwent open AUS implantation. There were seven (11.1%) intraoperative complications. At the last follow up, 26 (41.3%) initial AUSs remained in situ and 21 (33.3%) patients had at least one revision or reimplantation. Of these 47 patients (74.6%), 35 (74.5%) were fully continent, 3 (6.4%) had improved incontinence, and 9 (19.1%) had unchanged incontinence. A total of 20 patients (31.7%) experienced postoperative complications, but only 2 (3.2%) were Clavien ⩾3. After a median follow up of 14 ± 6 years, 20 (31.7%) explantations and 29 (46%) revisions occurred. The average time without explantation or revision was 11.6 and 9 years, respectively. Conclusions: In our experience, AUS is a good option for women with moderate to severe SUI, with good long-term outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Outcomes of open artificial urinary sphincter in women with stress urinary incontinence: long-term follow up

Tricard

Jochum

Bergerat

et al. 2019

Therapeutic Advances in Urology

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“…Indeed, existing data only compared retrospective-design studies and suggested that the robot-assisted approach compared with the open approach could decrease postoperative complication rates, without a significant difference in the intraoperative complication rate, blood loss, length of hospital stay, and the continence rate [22]. A systematic review [12] reported that while the open technique was performed more frequently, laparoscopic and robotic techniques reported similar outcomes, bearing in mind the small number of patients included and the shorter follow-up. Current data are still insufficient to determine whether the robotic approach meets the quality standards of open AUS implantation in the long term.…”

Section: Mucp Cmh 2 O Median (Iqr) 20 (14-25)mentioning

confidence: 99%

Robot‐assisted laparoscopic artificial urinary sphincter insertion in women with stress urinary incontinence: a pilot single‐centre study

et al. 2020

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Objective To report the functional outcomes of robot‐assisted laparoscopic artificial urinary sphincter (AUS; AMS 800™, American Medical Systems, Minnetonka, MN, USA) implantation and revision in women with stress urinary incontinence (SUI). Patients and Methods A pilot prospective monocentric study included all consecutive female patients with SUI and undergoing an AUS surgery (implantation or revision) using a robotic approach between 2012 and 2018. The AUS was implanted through a transperitoneal robotic approach. The dissection of the bladder neck was initiated using a posterior approach with a permanent visual control. Intraoperative and early postoperative complications were reported (Clavien–Dindo classification). Continence was defined as no pad usage. Results A total of 41 patients, median (interquartile range [IQR]) age 67.5 (57–74.7) years were included. In the group of 27 patients undergoing an AUS implantation, one conversion to laparotomy, one bladder neck and one ureteric injury occurred. The AUS was not implanted in the two latest cases. Twelve minor (Clavien–Dindo Grade I–II) early postoperative complications occurring in 10 patients were reported. The median (IQR) follow‐up was 19 (11–27) months. The continence rate was 84% (21/25 patients). In the group of 14 patients undergoing an AUS revision, no vaginal or bladder injury was reported. One patient had a bowel injury with conversion to laparotomy without AUS insertion. Two major (Clavien–Dindo Grade III–V) early postoperative complications occurred in two patients: one intraoperative bowel injury, which ultimately resulted in the death of the patient and one device infection requiring an explantation of the AUS. The median (IQR) follow‐up was 18 (13.5–24.2) months. The continence rate was 83.3% (10/12 patients). Conclusion The results obtained after robot‐assisted laparoscopic AUS implantation among women are promising despite the significant morbidity due to previous pelvic surgeries. Longer follow‐up studies are needed.

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“…Nowadays, AMS 800 is the main treatment modality for constant moderate and severe PPI and remains the treatment of choice for male SUI. Moreover, AMS 800 implantation in selected groups of women with severe or recurrent SUI or neurogenic dysfunction has been performed during the past 3 decades in a few centers worldwide [59]. This instrument contains an inflatable occluding cuff, a pressure regulating balloon (PRB), and a control pump.…”

Section: Ams 800 (American Medical Systems Minnetonka Mn Usa)mentioning

confidence: 99%

Artificial Urinary Sphincter for Postradical Prostatectomy Urinary Incontinence — Is It the Best Option?

Yoo

2019

Int Neurourol J

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Male stress urinary incontinence (SUI) can undoubtedly reduce quality of life and promote personal distress and psychosocial alienation. The frequency of postprostatectomy urinary incontinence (PPI) counts on the characterization of urinary incontinence and the periods of patient follow-up. Operational therapeutics, for instance, urethral male slings and artificial urinary sphincters, are well-chosen as adequate and secure surgeries for male SUI in men with continual PPI when conservative treatment is ineffective. Over the former 2 decades, surgery has progressed regarding both operative approach and sling architecture. However, there are no guidelines about when surgery should be carried out and which is the most appropriate surgical option. In this review, we summarize recent advances in implantable devices for PPI and also discuss traditional surgical care. When we are planning the male PPI surgery, careful preoperative work-up should be performed and surgical method should be chosen according to the severity of the disease. Male sling is preferred in mild and moderate symptomatic patients with normal detrusor pressure and it is recommended to select traditional artificial urinary sphincter device in those with severe symptoms. It is expected that effective devices without adverse events will be developed with technical advances in near future.

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Performance and Safety of the Artificial Urinary Sphincter (AMS 800) for Non-neurogenic Women with Urinary Incontinence Secondary to Intrinsic Sphincter Deficiency: A Systematic Review

Cited by 30 publications

References 33 publications

Outcomes of open artificial urinary sphincter in women with stress urinary incontinence: long-term follow up

Outcomes of open artificial urinary sphincter in women with stress urinary incontinence: long-term follow up

Robot‐assisted laparoscopic artificial urinary sphincter insertion in women with stress urinary incontinence: a pilot single‐centre study

Artificial Urinary Sphincter for Postradical Prostatectomy Urinary Incontinence — Is It the Best Option?

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