Vol. 42 (3): 494-500, May – June, 2016
Transcorporal artificial urinary sphincter in radiated and non – radiated compromised urethra. Assessment with a minimum 2 year follow-up
Erwann Le Long 1, John David Rebibo 1, Francois Xavier Nouhaud 1, Philippe Grise 1
1 Department of Urology-Rouen University Hospital-Charles Nicolle, Rouen, France
Purpose: to assess the efficacy of transcorporal artificial urinary sphincter (AUS) im¬plantation on continence for male stress urinary incontinence in cases of prior surgical treatment or/and radiation failure, and as a first option in radiation patients.
Materials and Methods: From March 2007 to August 2012, 37 male patients were treated with transcorporal AUS AMS™ 800. Twelve patients had primary placement of transcorporal cuff, a surgical option due to a previous history of radiation and 25 patients had secondary procedure after failure of AUS or urinary incontinence surgery. Functional urinary outcomes were assessed by daily pad use, 24-hour Pad-test and ICIQ-SF questionnaire. Quality of life and satisfaction were assessed based on I-QoL and PGI-I questionnaires.
Results: After a median of 32 months, the continence rate (0 to 1 pad) was 69.7%. Me¬dian pad test was 17.5g (0-159), mean ICIQ-SF score was 7.3/21 (±5.4) and mean I-QoL score was 93.9/110. A total of 88% of the patients reported satisfaction with the AUS. The 5-year actuarial revision-free for AUS total device was 51%. Patients for primary implant for radiation were not more likely to experience revision than non-radiation patients. Preservation of erections was reported in half of the potent patients.
Conclusions: Transcorporal AUS cuff placement is a useful alternative procedure op¬tion for severe male UI treatment, especially in patients with a compromised urethra after prior surgery or radiation. A high continence rate was reported and implantation as first option in radiation patients should be considered.
Keywords: Suburethral Slings; Urinary Incontinence; Urogenital System; Radiation