Document Detail


Treatment of neurogenic male urinary incontinence related to intrinsic sphincter insufficiency with an artificial urinary sphincter: a French retrospective multicentre study.
MedLine Citation:
PMID:  20633005     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess results and morbidity of the periprostatic insertion of an artificial urinary sphincter (AUS) in adult male patients with a neurogenic bladder.
PATIENTS AND METHODS: A retrospective study was carried out on 51 adult male patients operated on in four urologic academic wards from April 1988 to January 2008. Among these patients, 31% (16/51) had spina bifida and 69% (35/51) had spinal cord injury. All patients suffered urinary incontinence secondary to sphincteric deficiency, and this was associated with detrusor overactivity in 39% of them (leading in these cases to an added bladder augmentation). Perfect continence was defined as a period of dryness of at least 4 h between two self-intermittent catheterizations (SIC) or spontaneous micturitions, moderate incontinence as nocturnal leakage or need to wear protection once during the day or for stress leakage, while severe incontinence was defined as uncontrollable leakage causing patient discomfort.
RESULTS: Mean age at the procedure was 35 years (18-58). Mean follow-up was 83 months (CI 95%, 65-101). At the end of the study, 15 patients (29.4%) were lost to follow-up. One patient (2%) died shortly after the procedure from a pulmonary infection. Post-operative morbidity was observed in 19% (10/50) of the patients (8 urinary tract infection, 1 failure to perform SIC, 1intracranial hypertension). Of the patients in our study 74% had perfect or moderate continence with a working AUS after a 10-year follow-up
CONCLUSIONS: We present a specific study on adult patients with a neurological lesion leading to bladder dysfunction treated by a periprostatic AUS. This procedure was effective in restoring urinary incontinence in the vast majority of our patients with an acceptable morbidity.
Authors:
Emmanuel Chartier Kastler; Sandra Genevois; Xavier Gamé; Pierre Denys; Francois Richard; Albert Leriche; Jean Pierre Saramon; Alain Ruffion
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  BJU international     Volume:  107     ISSN:  1464-410X     ISO Abbreviation:  BJU Int.     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-01-26     Completed Date:  2011-03-10     Revised Date:  2011-03-21    
Medline Journal Info:
Nlm Unique ID:  100886721     Medline TA:  BJU Int     Country:  England    
Other Details:
Languages:  eng     Pagination:  426-32     Citation Subset:  IM    
Copyright Information:
© 2010 THE AUTHORS. JOURNAL COMPILATION © 2010 BJU INTERNATIONAL.
Affiliation:
Service d'Urologie, Groupe hospitalier Pitié-Salpêtrière, Assistance Publique Hopitaux de Paris, Université Paris-VI, Paris, France.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Epidemiologic Methods
France
Humans
Male
Middle Aged
Spinal Cord Injuries / complications*
Spinal Dysraphism / complications*
Treatment Outcome
Urinary Bladder, Neurogenic / complications,  surgery*
Urinary Incontinence / etiology,  surgery*
Urinary Sphincter, Artificial*
Urologic Surgical Procedures, Male / methods*
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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