To evaluate the preoperative and intraoperative risk factors for revision after AUS implantation in male patients with stress urinary incontinence (SUI).
A retrospective analysis from a prospectively maintained database was performed. Male patients, with moderate-to-severe SUI, undergoing AUS implantation were included. All patients underwent placement of AMS 800™. Cause of revision, type of revision, and time to revision were recorded. Multivariable analyzes were performed using a logistic regression to investigate the risk factors. Competing risk analysis according to Fine-Gray model was used to study time to event data.
A total of 70 patients were included. Revision surgery was performed in 22/70 (31.4%) patients, after a median (IQR) time of 26.5 (6.5-39.3) months. Overall, 19/22 (86.4%) repairs and 3/22 (13.6%) explants were recorded. Mechanical dysfunction, urethral erosion, urethral atrophy, and device infection were the causes of revision in 11/22 (50.0%), 6/22 (27.3%), 3/22 (13.6%), and 2/22 (9.1%) patients. Vesicourethral anastomosis stenosis (p=0.02), urethral cuff size of 3.5 cm (p=0.029), and dual implantation (p=0.048) were independent predictors for revision. Vesicourethral anastomosis stenosis (p=0.01) and urethral cuff size of 3.5 cm (p=0.029) predicted a lower survival of the AUS.
The vesicourethral anastomosis stenosis, urethral cuff size of 3.5 cm, and dual implantation are independent predictors for revision after AUS implantation. However, only the vesicourethral anastomosis stenosis and urethral cuff size of 3.5 cm predict a lower survival of AUS.
International neurourology journal. 2022 Mar 08 [Epub ahead of print]
Celeste Manfredi, Pramod Krishnappa, Esaú Fernández-Pascu, Elena García-Criado, Diego Rengifo, David Vázquez Alba, Joaquín Carballido, Davide Arcaniolo, Juan Ignacio Martínez-Salama
Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy., Andrology Division, Department of Urology, NU Hospitals, Bangalore, India., Department of Urology, Hospital Universitario La Paz, Madrid, Spain., Department of Urology, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain., LYX Institute of Urology, Universidad Francisco de Vitoria, Madrid, Spain.