Document Detail


A comparison of the functional durability of the AMS 800 artificial urinary sphincter between cases with and without an underlying neurogenic aetiology.
MedLine Citation:
PMID:  14700117     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To compare the efficacy and functional durability of the American Medical Systems 800 (AMS 800) artificial urinary sphincter (AUS) device for patients with neurogenic and non-neurogenic incontinence. METHODS: From 1985 to 2000, 38 patients underwent implantation of an AMS 800 AUS at our institution. Thirty of these patients had complete records and follow-up data available. The mean follow-up for these two groups of patients was six years. Seventeen devices (57%) were implanted for non-neurogenic indications including incontinence after prostatectomy or hysterectomy. Thirteen devices (43%) were implanted for neurogenic conditions including spina bifida, spinal cord injury or severe pelvic trauma. The primary end point measured was continence. Secondary end points included mechanical and non-mechanical device failure, re-operation and complication rates between the two groups. RESULTS: In the neurogenic group, only two patients (15%) have their original device in situ without revisions. Only three patients (23%) in this group are entirely dry. In contrast, seven patients (41%) in the non-neurogenic group are completely dry with their original device in situ. A further four (23%) are entirely dry after device revision or replacement surgery. The rates of mechanical failure were not statistically different between the two groups. The rate of non-mechanical failure (NMF) was statistically greater in the neurogenic group in comparison to that in the non-neurogenic group (p < 0.05). CONCLUSIONS: Insertion of an AMS 800 artificial sphincter remains a durable means of regaining urinary continence. Patients who are incontinent as a result of an underlying neurological deficit should be counselled that they might have a higher risk of non-mechanical device failure, requirement for re-operation and that their overall long-term continence rates may be poor.
Authors:
S Murphy; D Rea; J O'Mahony; T E D McDermott; J Thornhill; M Butler; R Grainger
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Irish journal of medical science     Volume:  172     ISSN:  0021-1265     ISO Abbreviation:  Ir J Med Sci     Publication Date:    2003 Jul-Sep
Date Detail:
Created Date:  2003-12-31     Completed Date:  2004-06-24     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7806864     Medline TA:  Ir J Med Sci     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  136-8     Citation Subset:  IM    
Affiliation:
Department of Urology, Adelaide Hospital, Tallaght, Dublin, Ireland. smurphy@bccancer.bc.ca
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Equipment Design
Equipment Failure
Female
Follow-Up Studies
Humans
Hysterectomy / adverse effects
Male
Middle Aged
Prostatectomy / adverse effects
Urinary Bladder, Neurogenic / etiology,  surgery*
Urinary Incontinence / etiology,  surgery*
Urinary Sphincter, Artificial*

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


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