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Int. braz. j. urol ; 42(3): 494-500, tab, graf
Article in English | LILACS | ID: lil-785716

ABSTRACT

ABSTRACT Purpose to assess the efficacy of transcorporal artificial urinary sphincter (AUS) implantation on continence for male stress urinary incontinence in cases of prior surgical treatment or/and radiation failure, and as a first option in radiation patients. Materials and Methods From March 2007 to August 2012, 37 male patients were treated with transcorporal AUS AMS™ 800. Twelve patients had primary placement of transcorporal cuff, a surgical option due to a previous history of radiation and 25 patients had secondary procedure after failure of AUS or urinary incontinence surgery. Functional urinary outcomes were assessed by daily pad use, 24-hour Pad-test and ICIQ-SF questionnaire. Quality of life and satisfaction were assessed based on I-QoL and PGI-I questionnaires. Results After a median of 32 months, the continence rate (0 to 1 pad) was 69.7%. Median pad test was 17.5g (0-159), mean ICIQ-SF score was 7.3/21 (±5.4) and mean I-QoL score was 93.9/110. A total of 88% of the patients reported satisfaction with the AUS. The 5-year actuarial revision-free for AUS total device was 51%. Patients for primary implant for radiation were not more likely to experience revision than non-radiation patients. Preservation of erections was reported in half of the potent patients. Conclusions Transcorporal AUS cuff placement is a useful alternative procedure option for severe male UI treatment, especially in patients with a compromised urethra after prior surgery or radiation. A high continence rate was reported and implantation as first option in radiation patients should be considered.


Subject(s)
Humans , Male , Aged , Urethra/surgery , Urethra/radiation effects , Urinary Incontinence, Stress/surgery , Urinary Sphincter, Artificial , Postoperative Complications , Prostatectomy/adverse effects , Quality of Life , Time Factors , Urinary Incontinence, Stress/etiology , Urinary Incontinence, Stress/radiotherapy , Penile Erection , Surveys and Questionnaires , Reproducibility of Results , Retrospective Studies , Follow-Up Studies , Treatment Outcome , Statistics, Nonparametric , Disease-Free Survival , Kaplan-Meier Estimate , Middle Aged
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