Document Detail


25-year experience in the outcome of artificial urinary sphincter in the treatment of female urinary incontinence.
MedLine Citation:
PMID:  20500509     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To report the outcome of artificial urinary sphincter (AUS) in female patients for the treatment of stress urinary incontinence (SUI).
PATIENTS AND METHODS: We retrospectively reviewed all female patients with AUS implanted over the last 25 years in one institution. Patient demographics, renal tract imaging and urodynamics assessment were documented. Outcomes measures included complications, duration and cause of AUS failure. Urinary continence was defined as no pad use after AUS insertion. AUS failure was defined as malfunction, infection or erosion. AUS malfunction included either mechanical (fluid leak) or non-mechanical (infection or surgical damage to AUS). A Kaplan-Meier analysis was used to determine device failure over time.
RESULTS: In all, 47 consecutive women with a mean (range) age of 51 (17-78) years received an AUS for the treatment of UI. Of these, 35 women had failed anti-incontinence surgery previously. There were two wound infections after AUS insertion but no mortality. Of the 47 AUS implanted, 39 (83%) AUS remained in situ. Eight (17%) AUS were removed due to AUS erosion or infection. There were 20 AUS revisions, 16 of which were primary AUS revisions. Most of the AUS revisions were related to mechanical malfunctions. Comparison of the proportion of AUS device survival over time using Kaplan-Meier analysis showed >80% of AUS remained functioning after 100 months. At the time of review, 83% of patients had a device in situ and the continence rate with no pads use was 59% with AUS only; this figure increased to 85% when concurrent clean intermittent self-catheterization was performed.
CONCLUSIONS: AUS is an effective and durable treatment option for female SUI. In properly selected women, high continence rates can be achieved. Most patients maintained satisfactory long-term continence rates despite revision surgery.
Authors:
Eric Chung; Ross A Cartmill
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  BJU international     Volume:  106     ISSN:  1464-410X     ISO Abbreviation:  BJU Int.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-16     Completed Date:  2011-01-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100886721     Medline TA:  BJU Int     Country:  England    
Other Details:
Languages:  eng     Pagination:  1664-7     Citation Subset:  IM    
Copyright Information:
© 2010 THE AUTHORS. JOURNAL COMPILATION © 2010 BJU INTERNATIONAL.
Affiliation:
Department of Urology, Princess Alexandra Hospital, Queensland, Australia. ericchg@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Epidemiologic Methods
Female
Humans
Middle Aged
Patient Satisfaction
Reoperation
Treatment Outcome
Urinary Incontinence, Stress / surgery*
Urinary Sphincter, Artificial*
Young Adult

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