We analysed the impact of predefined risk factors: age, diabetes, history of pelvic irradiation, prior surgery for stress urinary incontinence (SUI), prior urethral stricture, additional procedure during SUI surgery, duration of incontinence, ASA-classification and cause for incontinence on failure and complications in male SUI surgery.
We retrospectively identified 506 patients with an artificial urinary sphincter (AUS) and 513 patients with a male sling (MS) in a multicenter cohort study. Complication rates were correlated to the risk factors in univariate analysis. Subsequently, a multivariate logistic regression adjusted to the risk factors was performed. A p value <0.05 was considered statistically significant.
A history of pelvic irradiation was an independent risk factor for explantation in AUS (p < 0.001) and MS (p = 0.018). Moreover, prior urethral stricture (p = 0.036) and higher ASA-classification (p = 0.039) were positively correlated with explantation in univariate analysis for AUS. Urethral erosion was correlated with prior urethral stricture (p < 0.001) and a history of pelvic irradiation (p < 0.001) in AUS. Furthermore, infection was correlated with additional procedures during SUI surgery in univariate analysis (p = 0.037) in MS.
We first identified the correlation of higher ASA-classification and explantation in AUS. Nevertheless, only a few novel risk factors had a significant influence on the failure of MS or AUS.
Urologia internationalis. 2016 Sep 03 [Epub ahead of print]
Tanja Hüsch, Alexander Kretschmer, Frauke Thomsen, Dominik Kronlachner, Martin Kurosch, Alice Obaje, Ralf Anding, Tobias Pottek, Achim Rose, Roberto Olianas, Alexander Friedl, Wilhelm Hübner, Roland Homberg, Jesco Pfitzenmaier, Ulrich Grein, Fabian Queissert, Carsten Maik Naumann, Josef Schweiger, Carola Wotzka, Joanne Nyarangi-Dix, Torben Hofmann, Kurt Ulm, Ricarda M Bauer, Axel Haferkamp, Debates on Male Incontinence (DOMINO)-Project
University Medical Center of Johannes Gutenberg University Mainz, Department of Urology and Pediatric Urology, Main, Germany.