The aim of the study was to report the very long-term functional outcomes of artificial urinary sphincter (AUS) in male neurological patients.
Male neurological patients diagnosed with stress urinary incontinence due to sphincter deficiency and undergoing AUS (AMS 800(®)) implantation between 1985 and 1992 were enrolled. Continence, defined by no pad/condom usage, explantation and revision rates were reported.
Fourteen patients with a median age of 27.3 years (IQR: 27.3-40.8) were included: four had a spinal cord injury and ten a spina bifida. Prior continence surgery was reported by 6 patients (42.9 %). Artificial urinary sphincter was implanted in a peribulbar (n=4) or periprostatic position (n=10). Median follow-up was 18.3 years (IQR: 10.1-20.3). At last follow-up, all patients were alive. Three native devices were still in place, eight were revised (four of them were secondarily explanted) and three were explanted due to erosion or infection. The 5-, 10-, 15-, 20-year explantation-free survival rates were respectively 85.7, 62.3, 52.0, 39.0 %. The 5-, 10-, 15-, 20-year revision-free survival rates were respectively 78.6, 42.9, 28.6, 7.1 %. At last follow-up, 50 % patients were continent.
In the very long run, AUS provided a 50 % continence rate in male neurological patients but the revision rates were important.
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Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie. 2017 Nov 01 [Epub ahead of print]
C Guillot-Tantay, E Chartier-Kastler, P Mozer, M-O Bitker, F Richard, V Ambrogi, P Denys, P Léon, V Phé
Service d'urologie et de transplantation rénale, hôpital universitaire La Pitié Salpêtrière, Assistance publique-Hôpitaux de Paris, faculté de médecine Pierre et Marie Curie, Sorbonne universités, université Paris 6, 47-83, boulevard de L'hôpital, 75013 Paris, France. Electronic address: ., Service d'urologie et de transplantation rénale, hôpital universitaire La Pitié Salpêtrière, Assistance publique-Hôpitaux de Paris, faculté de médecine Pierre et Marie Curie, Sorbonne universités, université Paris 6, 47-83, boulevard de L'hôpital, 75013 Paris, France., Service de médecine physique et réadaptation, hôpital Raymond-Poincaré, Assistance publique-Hôpitaux de Paris, UFR des sciences de la santé Simone Veil, université Versailles-Saint-Quentin-en-Yvelines, 104, boulevard Raymond-Poincaré, 92380 Garches, France.