Quality of life after radical prostatectomy: Continuing to improve on our track record

Chan, Garson; Pautler, Stephen E.

doi:10.5489/cuaj.2999

Cited by 1 publication

(1 citation statement)

References 13 publications

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“…Urinary incontinence, the involuntary urethral loss of urine, can be caused by radical prostatectomy through a direct injury of the urethral sphincter or as a consequence of bladder denervation, resulting in bladder dysfunction such as detrusor overactivity ( 3 ). While a small amount of incontinence may not cause problems, larger degrees of incontinence can lead to major impact on a patient’s quality of life ( 4 ). In these cases, when incontinence persists despite conservative therapy, the implantation of an artificial urinary sphincter (AUS) may be recommended ( 5 , 6 ).…”

Section: Introductionmentioning

confidence: 99%

Artificial urinary sphincter for urinary incontinence after radical prostatectomy: a historical cohort from 2004 to 2015

et al. 2017

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This study aimed to retrospectively evaluate a cohort of patients with prostate cancer and persistent urinary incontinence after radical prostatectomy. From January 2004 to December 2015, eighty-six individuals were identified to have received an AUS implant, provided by a private nonprofit HMO operating in Belo Horizonte, Brazil. On total, there were 91 AUS implants, with a median interval between radical prostatectomy and AUS implant of 3.6 years (IQR 1.9 to 5.5). The rate of AUS cumulative survival, after a median follow-up of 4.1 years (IQR 1.7-7.2 years), was 44% (n=40). The median survival of AUS implants was 2.9 years (IQR 0.5-7.9 years). Thirty-seven AUS implants (40.7%) resulted in grade III surgical complications. There were 5 deaths at 2.1, 4.7, 5.7, 5.7 and 6.5 years of follow-up, but none due to causes directly associated to the AUS implant. Persistent severe incontinence was documented in 14 (15.3%) additional patients. From the 51 AUS implants which resulted in grade III surgical complications or persistent severe incontinence, 24 (47.1%) underwent surgical revisions. Explantation of the sphincter or its components was observed in 6 cases (25.0%). Mechanical failure, described as fluid loss and/or inability to recycle the AUS device, was observed in 4 devices (16.7%). In conclusion, although AUS implants are recommended as the gold-standard treatment of severe urinary incontinence after prostatectomy, the observed high rates of malfunction and grade III adverse events are a matter of concern warranting further assessment on the safety and efficacy of these devices.

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