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AUA 2019

AUA 2019: A New Artificial Urinary Sphincter (VICTO) with Conditional Occlusion for Male Stress Incontinence: Preliminary Clinical Results

Chicago, IL (UroToday.com) A Group of Austria showed the safety and efficacy of a new Artificial Urinary Sphincters (AUS), VICTO is a single unit pre-connected adjustable device with an occluding cuff (OC), a pressure regulating balloon and a scrotal pump with a self-sealing port for pressure adjustment. VICTO plus has additionally a stress relief balloon to transmit transient intraabdominal pressure changes to the OC. The regulating pressure is adjustable in the range 0-100 cmH2O and can be altered at any time after implantation by injection or removal of fluid. In the time between 12/2016 and 10/2018 the device was indicated in 52 patients with SUI after prostate surgery (prostatectomy n=45; transurethral prostate resection n=4; traumata=3). We included the data from 45 patients (VICTO n=18, VICTO plus n=27) with a mean follow-up time of 10.1 months (range 1.2-21.1). Patients with more than 2 prior incontinence surgeries were excluded (n=2) and 5 systems were not activated at the time of the data collection. We used a telephone questionnaire to collect postoperative data as daily pad use and satisfaction rate. Average age at time of implantation was 69.5 years. There were between 1 to 5 (IQR=1.5, M=1) readjustment needed to achieve a sufficient result.

In all 45 cases the device was easily implanted without any intraoperative complications. One patient with persistent incontinence after VICTO-Implantation required a smaller OC. The pad per day usage improved from 6.4 to 1.6 and the continence rate (max. 1p/d) was 53,3%. The overall satisfaction was 83,8% and 88,6% would undergo the same operation again. Only 4 patients had an improvement less than 50%, all of them are not fully activated yet and may improve more with future adjustments.

They concluded that the device provides adjustability in regulating pressure in situ. In this study there was 45 patients, 91,1% had at least an improvement of 50% and these short results are promising and challenge prior AUS series. Adjusting the system pressure to the lowest level providing continence may reduce the long-term rate of erosions and &[Prime]sub cuff atrophy&[Prime], however such data are not yet available

Presented by: Peter Weibl, MD, PhD,Associate Professor, Korneuburg, Austria, Deputy of head physician (chief senior consultant) of Urologic Department
Co-Authors: Ghazal Ameli, Michael Rutkowski, Wilhelm Alexander Huebner, Korneuburg, Austria

Written by: Bilal Farhan, MD, Clinical Instructor, Female Urology and Voiding Dysfunction, Department of Urology, University of California, Irvine @BilalfarhanMD at the American Urological Association's 2019 Annual Meeting (AUA 2019), May 3 – 6, 2019 in Chicago, Illinois