RESUMO
PURPOSE: The aim was to study the correlation between cuff size and outcome after implantation of an AMS 800 artificial urinary sphincter. METHODS: A total of 473 male patients with an AMS 800 sphincter implanted between 2012 and 2014 were analyzed in a retrospective multicenter cohort study performed as part of the Central European Debates on Male Incontinence (DOMINO) Project. RESULTS: Single cuffs were implanted in 54.5% and double cuffs in 45.5% of the patients. The cuffs used had a median circumference of 4.5 cm. Within a median follow of 18 months, urethral erosion occurred in 12.8% of the cases and was associated significantly more often with small cuff sizes (P<0.001). Multivariate analysis showed that, apart from cuff size (P=0.03), prior irradiation (P<0.001) and the penoscrotal approach (P=0.036) were associated with an increased erosion rate. Continence rate tended to be highest with median cuff sizes (4–5.5 cm). CONCLUSIONS: Apart from irradiation and the penoscrotal approach, small cuff size is a risk factor for urethral erosion. Results are best with cuff sizes of 4.5–5.5 cm.
Assuntos
Humanos , Masculino , Estudos de Coortes , Análise Multivariada , Estudos Retrospectivos , Fatores de Risco , Esfíncter Urinário ArtificialRESUMO
A 31 year old male patient presenting urinary incontinence 2 years after the traumatic injury of the posterior urethra and bladder neck, fails to respond to the alpha-adrenaergic agents and other ordinary methods. However, using the artificial sphincter(Model AMS 800) implantation, he successfully voided freely without urinary incontinence and the residual urine. The urethral closing pressure was significantly increased. The radiographic findings of inflation and deflation of the sphincter revealed satisfactory functions.
Assuntos
Adulto , Humanos , Masculino , Inflação , Pescoço , Uretra , Bexiga Urinária , Incontinência UrináriaRESUMO
Urinary incontinence is one of the most distressing problems in urologic practice. However, recent advances in implantable devices have significantly improved the outlook for patients with incontinence due to sphincter weakness. Herein we report a case of urinary incontinence treated by artificial sphincter (model AMS 800) implantation. A 25-year-old man presented with continuous and total incontinence, which developed after pelvic bone fracture and urethral injury. cystometry was normal, uroflowmetry and urethrography showed no significant bladder outlet obstruction, and urethral closing pressure was significantly decreased. After artificial sphincter implantation to the bladder neck. the patient showed good results both clinically and urodynamically.