Artificial urinary sphincter implantation with periprostatic cuff placement for urinary incontinence in men.

Artificial urinary sphincter (AUS) implantation is the treatment of choice for male urinary incontinence (UI). The aim of the present study was to evaluate treatment outcomes of UI in men using an AUS with a cuff placed around the prostatic urethra.

Forty-three men with preserved prostatic urethra were selected for AUS implantation due to UI. Twenty patients had the cuff implanted around the prostate using the retropubic approach (Group 1), and 23 had the cuff placed around the bulbous urethra (Group 2). Both groups were compared in terms of continence quality as well as intra- and postoperative complications.

The groups were comparable with respect to age and duration of follow-up. Median time to complications was 90.3 and 10.7 months in Group 1 and Group 2, respectively (p = 0.007). The complication rate was 40% and 58.3% in Group 1 and 2, respectively (p = 0.001). Complete continence was obtained in 80% of patients from Group 1 and 33.3% of men from Group 2A (p = 0.001).

The analysis indicates that cuff placement around the prostatic urethra results in better continence and is characterised by fewer complications. This method is dedicated for patients who have not had the prostate gland removed. Due to the retrospective nature of this analysis and small groups of patients, it is not possible to formulate ultimate recommendations.

Archives of medical science : AMS. 2020 Feb 04*** epublish ***

Tomasz Szopiński, Iwona Sudoł-Szopińska, Anna K Czech, Jerzy Gąsowski, Piotr L Chłosta

Department of Urology, Collegium Medicum, Jagiellonian University, Krakow, Poland., Department of Radiology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland., Department of Internal Medicine and Gerontology, Collegium Medicum, Jagiellonian University, Krakow, Poland.