Artificial sphincter “BR – SL – AS 904” in the treatment of urinary incontinence after radical prostatectomy: efficacy, practicality and safety in a prospective and multicenter study

Vol. 44 (6): 1215-1223, November – December, 2018

doi: 10.1590/S1677-5538.IBJU.2018.0128


ORIGINAL ARTICLE

Salvador Vilar Correia Lima 1, 2, Evandilson Guenes Campos de Barros 1, Fabio de Oliveira Vilar 1, Flavia Cristina Morone Pinto 2, Thomé Décio Pinheiro Barros 1, 2, José Carlos Truzzi 3, Luiz Gustavo M. de Toledo 4, Francisco Kanasiro 5, João Luiz Amaro 6
1 Serviço de Urologia, Hospital das Clínicas, Universidade Federal de Pernambuco, UFPE, Recife, PE, Brasil; 2 Departamento de Cirurgia, Centro de Ciências da Saúde, Universidade Federal de Pernambuco, UFPE, Recife, PE, Brasil; 3 Departamento de Urologia, Instituto do Câncer Dr. Arnaldo Vieira de Carvalho, São Paulo, SP, Brasil; 4 Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brasil; 5 Serviço de Urologia, Hospital Santa Marcelina, Porto Velho, RO, Brasil; 6 Disciplina de Urologia, Unesp – Universidade Estadual Paulista, São Paulo, SP, Brasil

ABSTRACT

Purpose: The objective of the present study is to test the efficiency and practicality of a new artificial sphincter “BR – SL – AS – 904” in the control of urinary incontinence in post – PR patients and to evaluate their complications.

Patients and Methods: Fifteen patients with incontinence after one year of radical prostatectomy were included prospectively. All patients underwent artificial urethral sphincter (AUS) implant “BR – SL – AS – 904” according to established technique. Inde­pendent variables such as free urinary flow, PAD weight test, ICIQ – SF score and uri­nary symptoms through the IPSS score were compared in different follow-up moments.

Results: Patients submitted to AUS implantation did not present trans – operative or post – operative complications related to the surgical act such as: infection, hematoma, erosion or urinary retention. Device was inert to the body during the follow-up, sho­wing an excellent adaptation of the patients, besides the easy handling. The mean age was 68.20 years 40% of the patients had systemic arterial hypertension, 6.7% diabetes mellitus, 6.7% were hypertensive and diabetic, 13.4% were hypertensive, had diabetes and hypercholesterolemia and 26.7% patients had no comorbidities. It was evidenced that the urinary flow peak during the follow-up remained stable. Decreased averages and median PAD weight test were 135.19 to 75.72 and 106.00 to 23.50, respectively. The IPSS score decreased and the quality of life increased (12.33 to 3.40 and 2.50 to 3.20 respectively). The ICQF – SF questionnaire score also showed a decrease, ranging from 16, 71 to 7.33.

Conclusion: The artificial sphincter implant “BR – SL – AS 904” was reproducible, safe and effective in the control of urinary incontinence in post – PR patients.

Keywords: Urinary Incontinence; Urinary Sphincter, Artificial; Prostatic Neoplasms

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